issue 24, june, 2004 - burma library final issues/issue 24.pdf · issue 24, june, 2004 3...

ISSUE 24, JUNE, 2004 1

2 usef;rma&;apwrmeftrSwf=24 ZGefv 2004 ckESpf?

rmwdumCONTENTS

trSwf 24 ZGefv 2004 ckESpf? ISSUE 24 JUNE, 2004

2

This text has been produced with financial assistance from IRC/USAID and printing costs supported by WHO.The views expressed herein, in no way reflect the official opinion of IRC/USAID and WHO.The procedures, explanations and treatments provided in this publication are based on research and consultation withmedical and nursing authorities. They all reflect accepted medical practices. Nevertheless they cannot be considered asabsolute and universal recommendations. The authors, the editor and the publisher disclaim responsibility for anyadverse effects resulting directly or indirectly from the suggested procedures, from any undetected errors, or from thereader's misunderstanding of the text.

jrefrmvdk bmomjyefay;aom bmomjyefq&mrsm;/ t*Fvdyfvdk y&kyfzwfay;aom rpPwmpwD;zefvkufESifh yef;csDq&m qkcspfrif;rvDwdk@tm; aus;Zl;wif&Sdygonf?Thanks to our translators for Burmese translation, Mr. Stephen Look for English proof-reading, Mr. Suchit Mingmalee for drawings.

?

oef@&Sif;a&; / Sanitationa&&&dS ay;a0jcif; (usef;rma&;apwrmeftzGJ@)

Water Supply (Health Messenger Team)oifhav#mfaomenf;jzifh tnpfta=u;rsm;pGef@ypfjcif; (tJvpfpbuf tDrmpef/ urBmhusef;rma&;tzGJ@)Appropriate Disposal of Excreta (Elisabeth Emerson,WHO)aq;&kHpGef@ypfypPnf;tygt0if trd_ufpGef@jcif; (tJvpfpbuf tDrmpef/ urBmhusef;rma&;tzGJ@)Disposal of Solid Waste, including Medical Waste (Elisabeth Emerson,WHO)

taxGaxGusef;rma&; / General Healthtjzpfrsm;onfh a&ESifhqufEG,faoma&m*grsm; (usef;rma&;apwrmeftzGJ@)

Common Water-Related Diseases (Health Messenger Team)

ukojcif; / Treatment0rf;ysuf0rf;av#ma&m*grsm;twGuf vufawG@vdkufem&ef vrf;n$efcsufrsm; (usef;rma&;apwrmeftzGJ@)

Practical Guidelines for Diarrhoea (Health Messenger Team)

}udKwifumuG,fjcif; / Prevention=uGufESdrfeif;a&; (usef;rma&;apwrmeftzGJ@)

Rodent Control (Health Messenger Team)

vkyfief;cGifrS / From the Field'v+rdK@wGif at/ trf/ tdkif .a&ESifhoef@ &Sif;r_vkyfaqmifcsufrsm;(usef;rma&;apwrmeftzGJ@ESihf at/ trf/ tdkif - jrefrm wdk@yl;wGJa&;om;onf )

AMI Water and Sanitation Activities in Dala(Health Messenger Team in Collaboration with AMI-Myanmar)

awG@qHkar;jref;jcif; / Interviewa&oHk;pGJolrsm; ESifh awG@qHkar;jreff;jcif; (usef;rma&;apwrmeftzGJ@ESihf at/ trf/ tdkif - jrefrm wdk@yl;wGJa&;om;onf )

Interview with Water Users (Health Messenger Team in Collaboration with AMI-Myanmar)

usef;rma&;ynmay; / Health Educationaea&mifjcnfjzifh a&tm; ydk;oef@pifjcif; (usef;rma&;apwrmeftzGJ@)

Water Disinfection By Sun (Health Messenger Team)npfywfaomrif;om; (usef;rma&;apwrmeftzGJ@ESihf ygwempf wdk@yl;wGJa&;om;onf )

The Prince of Dirty (Health Messenger Team in Collaboration with Partners)

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t,f'Dwmhtmabmf Editorial

Health Messenger Magazine Program117/9 Sukhumvit Soi 4, Soi Samaharn, Klongtoey, Bangkok 10110 Thailand.

Tel: 02 656 7136, 02 656 9370, Tel/Fax: 02 656 8869, E-mail: [email protected]

Editor/t,f'Dwm Dr Than

Editorial Advisors/t,f'Dwmht}uHay;yk*~dKvfrsm; Jaruwan Abella, Marie-Theres Benner, Dr Nicolas Durier,Elisabeth Emerson, Philip Galvin, Htaw Lin, Andrea Menefee,

Dr Cynthia Maung, Aree Moungsookjaroen, Dr Naing,

Dr Jonathan Nield, Dr Francois Nosten, Pranee Ontawong

Project Coordinator/!‡dE_dif;aqmif‡Gufol Veronique Terrasse

Administrator/tkyfcsKyfa&;rSL; Punyanuch Promngam

Distribution Manager/jzef@csDa&;refae*sm Prayad Trakarnsupakorn

cspfcifav;pm;tyfaompmzwfy&dowfrsm;cifAsm;/

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,ckpmapmifwGif yg0ifaomaqmif;yg;rsm;onf'kuQonfrsm;ESifh a&$‡ajymif;vkyfom;rsm;twGuf ta&;}uD;onfh a&ESifhoef@&Sif;r_ta=umif;udk OD;wnfxm;onf?trsdK;rsdK;aom a&&&dSay;a0r_/ a&ESifhqufEG,faom a&m*grsm;/ tnpfta=u; pGef@ypfjcif;ESifh =uGufESdrfeif;a&; ponfhta=umif;t&mrsm;tm; a&;om;wifjyxm;ygonf?

&$ifvef;pGmzwf&_Edkifygap!

av;pm;pGmjzifha'gufwmoef;t,f'Dwm

Dear Readers,

This issue is the result of joint efforts withWHO (World Health Organization), which isfunding its printing costs.

Some articles in this issue aim at helpinghealth workers as well as community membersto learn more about water supply and sanitation,and how to control the negative health effectsresulting from their surrounding environments.

The articles focus on water and sanitation,which is an important problem for refugees andmigrant workers. We are providing informationon different kinds of water supply, water-related diseases, waste disposal and rodentcontrol.

Enjoy your reading!

Best regards,Dr. ThanEditor


a&&&dSh ay;a0jcif;usef;rma&;apwrmeftzGJ@

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euf&d_if;aoma&wGif;Deep well

wdrfaoma&wGif;Shallow well


This article demonstrates the different sources of water supply and will help themedics, public health technicians and social workers in protecting the water points.

W a t e r S u p p l yHealth Messenger Team

What are the different types of water?Potentially, three types of water are available

for water supply: surface water, ground waterand rainwater.

What are the varieties of surface water?The varieties of surface water are streams,

rivers, lakes, ponds and reservoirs (dams).

How many types of ground water areavailable for water supply?

Two main types of ground water areavailable for water supply. These are deepground water and shallow ground water. Deepground water supplies are boreholes, deepwells and deep springs. On the other hand,shallow wells, shallow springs and groundwater near the water sources are different types

rl&if; - Source: Quyen Tran

of shallow ground water.

What are the main characteristics ofsurface water?

Surface water is generally heavily polluted,particularly during the rainy season. Its quantityalso varies with the season. Most of the surfacewater needs complex treatment before use.

Nevertheless, certain catchment methods allowa significant improvement of water quality; forexample, shallow wells dug close to riverbanks(river water could be filtered through soil beforeit gets into the well).

What are the characteristics of deep groundwater?

The nature of deep ground water is clear

wdrfaoma&wGif; - Shallow well


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ajray:a&oHk;pGJaeyHk/ Using surface waterrl&if; - Source: Quyen Tran


PRIORITIES IN TERMS OF WATER SUPPLY

• Find out how the people go to collect water and where they defecate• Designate defecation site away from water points• Take specific steps to PROTECT WATER POINTS• Determine the amount of water available• Look for additional sources of water• Create a reserve water stock• Check water quality• Install a treatment plant if feasible

a&o,faeyHk - Water transportationrl&if; - Source: Quyen Tran

and good bacteriological quality because ofhaving been filtered by percolation (liquidpassing through porous body) through rocks.Sometimes it contains substances, making itundrinkable because of its taste or because oftoxicity. There is a little or no seasonal changein terms of quantity and quality.

What is the main characteristics of shallowground water?

The main characteristics of shallow groundwater is the depth of the water table (body ofunderground water). When the water table ishigh, there is usually a lower bacteriologicalquality. Water from less than 3 meters deepshould be treated like surface water. It is alsosubject to seasonal variation in quantity.

What are the characteristics of rainwater?In non-industrialised regions, rainwater is

relatively pure and may be consumed withouttreatment as long as it is collected with certainprecautions, which are rainwater from a cleansurface (tin roof, tent, plastic sheeting) and thefirst flow of rainwater is rejected.

Although rainwater rarely provides a regularsupply, it may sometimes be a useful temporaryor complementary supply (it may be a goodalternative to heavily polluted surface waterduring the rainy season).

The exclusive consumption of rainwaterwithout a complementary intake of essentialminerals (such as iodine) causes problems inthe long term period.

Rainwater dissolves the metal in which it isstored. Do not use containers or pipes madeof copper, zinc or lead. Clay, cement or plasticcontainers are suitable.

What is the best source of water supplyfor the refugee situation?

When settlement begins, surface water (themost polluted or the most easily polluted) isoften the only supply available. It is, therefore,important to concentrate on the problem ofwater as a top priority.

In practice there is rarely a choiceamong these different sources of water,


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rl&if; - Source: AMI Myanmar Sanitation Project

a&yG dKif hrsm;udk }udKwifumuG,fjcif;a&yG d Kif hrsm;udk }udKwifumuG,fjcif;a&yG d Kif hrsm;udk }udKwifumuG,fjcif;a&yG d Kif hrsm;udk }udKwifumuG,fjcif;a&yG d Kif hrsm;udk }udKwifumuG,fjcif;

••••• a&pD;vrf;a=umif;rsm;udk }udKwifumuG,fjcif;a&pD;vrf;a=umif;rsm;udk }udKwifumuG,fjcif;a&pD;vrf;a=umif;rsm;udk }udKwifumuG,fjcif;a&pD;vrf;a=umif;rsm;udk }udKwifumuG,fjcif;a&pD;vrf;a=umif;rsm;udk }udKwifumuG,fjcif;ywf0ef;usifusef;rma&;pnf;urf;rsm;t& a&vrf;a=umif;rsm;udk jyKjyifxdef;odrf; pDpOfyg? a&v$Jaygufrsm;udk tjcm;a&toHk;jyKonfhae&mrsm;. a&pD;a=umif;txufydkif;wGif xm;&Sdyg? ajray:a&onfumuG,fr_jyK&ef t+rJwap cufcJwwfonf? xdk@a=umifhjzpfEdkifv#if tjcm;a&t&if;jrpfrsm;udk toHk;jyKyg? Oyrm- a&wGif;rsm;/ pdrfhwGif;rsm;ESifh ydkufoHk;t0DpDwGif;wdk@jzpfonf?

••••• a&wGif;rsm;tm; }udKwifumuG,fjcif;a&wGif;rsm;tm; }udKwifumuG,fjcif;a&wGif;rsm;tm; }udKwifumuG,fjcif;a&wGif;rsm;tm; }udKwifumuG,fjcif;a&wGif;rsm;tm; }udKwifumuG,fjcif;a&wGif;ywf0ef;usifudk wd&dp>mefrsm;r0ifa&mufEdkif&ef

a&xJodk@ wdkuf&dkufodk@r[kwf oG,f0dkufaomenf;jzifh rpifwGifyg0ifonfh a&m*gydk;rsm; ra&muf&Sdap &ef&nf&G,fcsufxm;+yD; a& yGdKifhtm;vHk;udk }udKwifumuG,fay;&rnf?


npfnrf;aoma& - Polluted water rl&if; - Source: Quyen Tran

particularly in emergency or refugeesituations.

Water points protection

All the protection measures aim atpreventing the introduction of faecalgerms into the water either directly orindirectly by dirty soil falling into thewater, etc.

••••• Protection of waterwayOrganise the use of the waterway accordingto environmental health considerations. Thepoint used for collecting water should beupstream of all other uses. Surface water

is always difficult to protect. If possible, useother sources such as wells, springs, andboreholes.

••••• Well protectionSurround the well with a fence againstanimals. If the well is used to water animals,make a channel to take water to a groovesituation outside the protective fence.Forbid the use of personal watercontainers. One rope with a single containershould be provided for this use. Install awinch or similar system so that the bucketand rope are not laid on the ground and sothat people do not lean over the well. Keepsources of pollution such as latrines, at least

30-50 meters awayfrom the well anddownhill from it if there isa slope (make sure thereare no fissured rocks).Make the upper part ofthe well watertight to atleast 3 meters deep,install an apron, aconcrete slab on the headwall, and drainage of thesurroundings, etc. Coverthe well, and if feasible,install a pump (hand ormotor-pump) including aplan for maintenance andthe supply of spare parts.

••••• Spring protectionInstall a system whichprevents water frompooling or collecting(standing) at the spring(collect the running waterwith a split bamboo, forinstance). Erect aprotective barrier aroundthe stream about 10


vufodk@r[kwf armfwmtoHk;jyKonfh wHkuif wyfqifay;yg? jyKjyif xdef;odrf;r_ESifhtydkypPnf;rsm; &&Sdap&efvnf; pDpOfay;yg?

••••• pdrfhwGif;tm; }udKwifumuG,fjcif;?pdrfhwGif;tm; }udKwifumuG,fjcif;?pdrfhwGif;tm; }udKwifumuG,fjcif;?pdrfhwGif;tm; }udKwifumuG,fjcif;?pdrfhwGif;tm; }udKwifumuG,fjcif;?pdrfhwGif;wGif a&0yfjcif;r&Sdap&ef tumtuG,fay;onfh tpDtpOf xm;&Sdyg? Oyrm - pdrfhwGif;rS a&udk0g;bdk;0g; jzifh jyKvkyfonfh a&wHavsmufjzifh a&udk cH,l+yD;toHk;jyKyg? prf;acsmif;.txuf 10 rDwmcef@wGif+cHum&H xm;yg? a&ajrmif;rsm; oG,fI a&npfnrf;r_r&Sdap&ef pDpOfyg?

a&npfnrf;jcif;a&npfnrf;jcif;a&npfnrf;jcif;a&npfnrf;jcif;a&npfnrf;jcif;

a&t&if;tjrpfESifh a&oHk;pGJonfhae&mrsm;=um;wGif rpifa=umifh a&npfnrf;r_rsm; ae&mra&G; jzpfEdkifonf?Oyrm/ a&wGif;rS a&onf- a&a=umwGif a&npfnrf;r_ jzpfjcif;- a&wGif;xJwGif&Sd a&tm; ajr}uD;rSwqifh npfnrf;apjcif;- a&o,f,lydk@aqmif&mwGif npfnrf;jcif; (npfayonfhyHk;rsm;/ vufrsm; ponfwdk@jzpfonf)- tdrfwGif odkavSmifxm;pOf npfnrf;jcif; (ydk;r$m;aumifrsm;/ zkHr_ef@rsm; ponfwdk@ jzpfonf)

pdrfhwGif;rSa&udk odkavSmifuefwnfaqmufI oHk;pGJyg?tdrfwGif a&npfnrf;r_jzpfjcif;xuf a&t&if;tjrpf

odk@r[kwf pkaygif;a&o,f,lydk@aqmifonfhtqifhwGif a&npfnrf;r_ jzpfjcif;onf ydkrd k pdk;&drfzG,faumif;onf?ta=umif;rlum; vltrsm;tkyfpktvdkuf wcsdefwnf; npfnrf;aoma&udk toHk;jyKv#if ul;pufuyfa&m*gtoGif jzpffEdkifaomtajctaea=umifh jzpfonf?

a&aumif;a&oef@oHk;pGJEdkif&eftwGuf tqifhtm;vHk;wGifjyifqifxm;&efvkdtyfonf? Oyrm - pdwfcs&aom a&ay;a0a&;pepf&Sdjcif; (a&yGdKifhrsm;tm;umuG,fr_ay;jcif;)/rpifrsm;tm; oef@&Sif;aom tdrfomrSwqifh pGef@ypfjcif;ESifha&&Snfusef;rma&; ynmay;jcif;wdk@ jzpfonf?

ISSUE 24, JUNE, 2004 11

POLLUTION

Faecal pollution of water may occur at a number of stages.For example, water from a well may be:- polluted at water table (body of water).- polluted inside the well from soil, run-off, etc.- polluted during transportation from dirty containers, dirty hands, etc.-polluted during storage in the home from insects, dust, etc.

pdrfhwGif;odkavSmifuef. ab;wapmif;yHk - Spring box side sectionrl&if; - Source: MSF

Pollution at the source of water or duringcollection transportating is nevertheless moredangerous than pollution at home: it affects thewhole population at once and consequentlyencourages large-scale epidemics.

metres above it. Dig a drainage channel tokeep it from being polluted by run off.

Build a spring box as soon as possible.

Consumption of clean water can only beachieved by action at all levels, with a globalprogramme of water point protection (safewater supply), excreta control (utilisation of

hygienic latrine) and long-term health education.

Reference:Public Health Technician in PrecariousSituation, MSF

a& - water

a&wm;ajrmif;Run-offdrainage ditch

&$H@ajrv$mLayer of clay

a&rpdrfhEdkifaomausmufzsmImperameable layer

a&v#HydkufOverflow

a&xkwfydkufDeliverypipe

ausmufpDxm;jcif;Stone wall

twm;qD; tumt&HProtective fence


? tjzpfrsm;onfh a&ESifhqufEG,faoma&m*grsm;usef;rma&;apwrmeftzGJ@

Taqmif;yg;wGif xdkif;-jrefrme,fpyfwpfav#mufwGif tjzpfrsm;aom a&rSwqifhul;pufapaom odk@r[kwfa&ESifhqufEG,faom a&m*grsm;ta=umif;udk &Sif;vif;wifjyxm;ygonf? xdk@tjyifTa&m*grsm;wpfa,mufrSwpfa,mufodk@ul;pufjyef@yGm;yHk/ a&m*gvQ%mrsm;ESifh

umuG,f&efenf;vrf;rsm;udkvnf;&Sif;vif;wifjyxm;ygonf?

a&ESifhqufEG,fI tjzpfrsm;aoma&m*grsm; rsm;pGm&Sdygonf? Ta&m*grsm;. a&ESifhrnfuJhodk@ qufEG,fonfhtay:rlwnfI trsdK;tpm;rsm; cGJjcm;xm;Edkifygonf?a&m*gydk;yg&Sdaom roef@&Sif;onfha&udk aomufoHk; rdaoma=umifhvnf;aumif;/tpm;taomufjyifqif&mwGif toHk;jyKrdaoma=umifhvnf;aumif; jzpfvmonfha&m*grsm;udka&rSwqifh o,faqmifaoma&m*grsm;a&rSwqifh o,faqmifaoma&m*grsm;a&rSwqifh o,faqmifaoma&m*grsm;a&rSwqifh o,faqmifaoma&m*grsm;a&rSwqifh o,faqmifaoma&m*grsm;[kac:qdkygonf?tcsdK@a&m*grsm;rSm a&ESifhxdawG@Ijzpfvm+yD; a&udka&udka&udka&udka&udk tajctajctajctajctajcjyKI jzpfvmaoma&m*grsm;jyKI jzpfvmaoma&m*grsm;jyKI jzpfvmaoma&m*grsm;jyKI jzpfvmaoma&m*grsm;jyKI jzpfvmaoma&m*grsm; [kac:qdkygonf? Ta&m*grsdK;rsm;wGif a&m*gjzpfapaomydk;onf ta&jym;udk xdk;azgufI 0ifEdkifygonf? a&awG@&SdEdkifaom rnfonhfae&mrqdka&m*go,faqmifaomydk;rsm; aygufyGm;&m ae&mjzpfEdkifygonf? Ta&m*grsdK;rsm;udk a&ESifhqufEG,fIydk;r$m;rSwqifha&ESifhqufEG,fIydk;r$m;rSwqifha&ESifhqufEG,fIydk;r$m;rSwqifha&ESifhqufEG,fIydk;r$m;rSwqifha&ESifhqufEG,fIydk;r$m;rSwqifho,faqmifaoma&m*grsm; o,faqmifaoma&m*grsm; o,faqmifaoma&m*grsm; o,faqmifaoma&m*grsm; o,faqmifaoma&m*grsm; [k trsdK;tpm;cJ G jcm;xm;ygonf? tcsdK@aoma&m*grsm;rSm a&vHkavmufpGm&&Sd+yD;aumif;rGefaom wudk,fa&oef@&Sif;a&;twGuf toHk;jyKEdkifygu Ta&m*grsm;udk umuG,fEdkifygonf? Ta&m*grsdK;rsm;udk a&aq;a&aq;a&aq;a&aq;a&aq;r_rSr_rSr_rSr_rSr_rS&aoma&m*grsm;&aoma&m*grsm;&aoma&m*grsm;&aoma&m*grsm;&aoma&m*grsm; [k trnfwwfEdkifygonf?

a&rSwqifho,faqmifaom a&m*grsm;

tjzpftrsm;qHk;aom a&rSwqifho,faqmifaoma&m*grsm;rSm 0rf;av#m0rf;ysufa&m*grsm; - 0rf;udkufjcif;/umv0rf;a&m*g/ wdkufzGdKufac:tla&mifief;zsm;a&m*g/tonf;a&miftom;0g "at"trsdK;tpm;ESifh tufpu&Da&;ppf(p)ac: oHvHk;aumifa&m*g/ trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm; yg0ifygonf? Ta&m*g rsm;onfrpif-yg;pyf vrf;a=umif; (ptdkrSyg;pyf) rS wqifhul;pufEdkifygonf? tcsdK@aom "gwkypPnf;rsm;onfvnf; a&rS wqifho,faqmifaom a&m*grsm;udk jzpfapEdkifygonf?

0r f ;y suf0r f ;av#ma&m*gr sm;0r f ;y suf0r f ;av#ma&m*gr sm;0r f ;y suf0r f ;av#ma&m*gr sm;0r f ;y suf0r f ;av#ma&m*gr sm;0r f ;y suf0r f ;av#ma&m*gr sm;- qdkonfrSm ta&0rf;oGm;jcif;/ 0rf;aysmhaysmhoGm;jcif;ESifhAdkufemjcif;/ &Hzef&Hcg rtDromjzpfjcif;paom a&m*gvuQ%mpkrsm;udk pkaygif;I ac:qdkjcif;jzpfygonf? Ta&m*grsdK;rsm;wGif a&m*gtvdkuf vlemwGif tzsm; &Sdcsif&Sdrnf/ r&SdbJ aecsifvnf;aernf/ 0rf;wGifvnf; aoG;ygcsif ygrnf/ rygcsifvnf; rygbJaernf? odk@&mwGifrsm;aomtm;jzifh tpmtdrf-tlvrf;a=umif;a&mifaom odk@r[kwf jyif;xefaom 0rf;av#m0rf;ysufa&m*grsm;onf rpif - yg;pyf vrf;a=umif;wpfav#mufa&m*gydk; yg0ifoGm;aoma=umifh jzpf&ygonf? 0rf;av#m0rf;ysufa&m*grsm;onf uav;i,frsm;twGuftE W&m,f=uD;rm;vSygonf/ ta&cef;ajcmufjcif;ESifhtm[m&csdK@wJh jcif;rsm; jzpfap+yD; toufaoqHk;Edkifonfhwdkifatmif jzpfapEdkifaoma=umifh jzpfygonf?0rf;udkufjcif; (aoG;ygaom0rf;av#m0rf;ysufjcif;)onftla&mifjcif;wpfrsdK;jzpf+yD; 0rf;xJwGifaoG;odk@r[kwfaoG;ESifhtc|Jyg0ifjcif;jzpfygonf? (usef;rma&;apwreftrSwf24 - 0rf;av#m0rf;ysufa&m*grsm;twGuf vkyfaqmif&rnfh vrf;n$efcsufrsm;udk =unfhyg)?


ISSUE 24, JUNE, 2004 13

?Common Water-Related DiseasesHealth Messenger Team

This article explains about the common diseases along the Thai-Burmese border thatare either transmitted by or linked to water. It also highlights the different routes of

transmission, the signs and symptoms, as well as preventive measures.

There are many common diseases, whichare related to water. These diseases can beclassified according to the link they have withwater. The diseases, which are transmittedthrough consumption of contaminated water bymouth or the use of it for food preparations arecalled water-borne diseases. Certain diseasesobtained by contact with water are namedwater-based diseases. In this case, the agentcausing the disease can penetrate the skin. Anywater site can be a place, where many disease-carrying insects breed. Most diseases aretransmitted through mosquitoes. These diseasesare classified as water-related vector-bornediseases. Some diseases can be prevented ifthere is a sufficient amount of water supply andit is used for good personal hygiene. Thesediseases are labelled as water washeddiseases.

Water-borne diseases

Most common water-borne diseases arediarrhoeal diseases including dysentery, cholera,typhoid, hepatitis A , ascariasis, amoebiasis andother protozoa diseases. These diseases aretransmitted through the faecal-oral (anus tomouth) route of transmission. Some chemicals(high content of Arsenic and Lead ) can alsocause water borne diseases.

Diarrhoea:Diarrhoea refers to a group of symptomssuch as watery stools, loose motions and

abdominal pain often accompanied bymalaise. Depending on the disease, thepatient may or may not have fever andstools may or may not contain blood.Most gastro-enteritis or acute diarrhoealdiseases are due to faecal-oralcontamination. Diarrhoea is verydangerous for children because ofdehydration and malnutrition, and maylead to death. Dysentery (bloodydiarrhoea) is an inflammation of theintestines with blood and/or mucus in thestools. (See: "Practical Guidelines forDiarrhoea" in this issue)

Amoebiasis:A protozoan named Entamoebahystolytica is the causative organism for thisdisease.

trDbm;ydk;Amoeba


trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm;trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm;trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm;trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm;trD;bm;ydk;a=umifhjzpfaom0rf;udkufESifhtjcm;a&m*grsm;y&dkwdkZdk;tm;tkyfpk0if tef@wftrD;bm;[pfpwdkvfvufwD;um;ac: uyfyg;ydk;wpfrsdK;a=umifh Ta&m*grsm;jzpfyGm; &onf?

ul;pufjyef@yGm;yHktlr}uD;xJwGif trD;bm;ydk;onf qpf(p)ac: tdwfi,fuav;rsm; xkwfvkyfay;onf? Ttdwfi,frsm; rpifxJwGifygoGm;+yD; olwdk@udk rsdKcsrdygu trD;bm;ydk;a=umifhjzpfaom 0rf;udkufESifhtjcm;a&m*grsm; ul;pufjzpfyGm;aponf? rpifrSyg;pyfxJodk@ wdkuf&dkuful;pufjyef@yGm;r_jzpfEdkifonf? odk@&mwGif ydkItjzpfrsm;aomul;pufenf;rSmtpm;taomufESifhaomufa&wGif tdwfi,f uav;(Cysts) rsm;ygaom rpifyg0ifaeonfh tpm;taomufrsm;rSwqifh jzpfwwf ygonf? xdka&tdwfi,fuav;rsm;ygaom tpm;taomufudk pm;aomufrdygu tlxJwGif trD;bm;uyfyg;aumifrsm;tjzpf =uD;xGm;vm+yD; vludka&m*g&apygonf?

a&m*gvuQ%mrsm;Adkufemjcif;/ tefjcif;/ tzsm;wufjcif;/ 0rf;oGm;jcif; -ta&0rf;rS 0rf;udkufonhfyHkpHjzpfaom 0rf;xJwGifaoG;ygjcif;/ c|JESifhjynfrsm;ygjcif;/ ponfwdk@jzpfEdkifonf?

a&m*gumuG,fjcif;Ta&m*gjzpfyGm;aeaom vlemrsm;/ a&m*go,faqmifaomolrsm;udk tpm;taomuf jyifqif&mwGif yg0ifvkyfaqmif&ef cGifhrjyKoifhyg? xdkolwdk@onf tdrfomoGm;+yD;wdkif; vufrsm;udk pif=u,fpGmaq;a=um&ygrnf?tpm;aomufrsm;udk a&m*gydk;rsm;jzifh rxdrdap&ef olwdk@onf rpifudk aumif;pGmjyKvkyfxm;aom ,ifvHktdrfomxJwGif pGef@&ygrnf? tpm; taomufrsm;udk aumif;rGefpGm usufatmif csuf&ygrnf? csuf+yD;aomtpm;taomufrsm;udkvnf; tkyfaqmif; ponfwdk@jzifhtkyfxm;&ygrnf?

umv0rf;a&m*gumv0rf;a&m*gumv0rf;a&m*gumv0rf;a&m*gumv0rf;a&m*g (Cholera)a&m*gjzpfyGm;apaom ydk;r$m;aumifrSm AGD b&D,dkaumfva&; ac:aom bufwD;&D;,m;ydk;wpfrsdK; jzpfygonf?vlemawmfawmfrsm;rsm;wGif a&m*gvuQ%mrsm; rjzpfay:yg/ odk@r [kwf a&m*gtaysmhpm;om jzpf=uonf?

ul;pufjyef@yGm;yHkumv0rf;a&m*gjzpfapaom aumfv&mbufwD;&D;,m;ydk;aumifrsm;onf vlem. tpmvrf;a=umif;rSwqifhrpif odk@r[kwf tefzwfrsm;rS jyifyokd@xGufvm=uonf?xdkydk;aumifrsm;onf tjcm;vlrsm;.yg;pyfrsm;xJodk@jyef@ESH@ukefonf? tpm; taomufrsm;udkvnf; vuf/,ifaumifrsm;ESifha&m*gydk; ygaeaoma&rSwqifh a&m*gydk;rsm; a&muf&SdapEdkifonf?

a&m*gvuQ%mrsm;jyif;xefaoma&m*gonfrsm;wGif Tumv0rf; a&m*gonf vsifjrefpGm (em&Dydkif;twGif;wGif) ta&cef;ajcmufjcif;/ aoG;vef@jcif;(Shock)ESifh toufaoonftxdjzpfapEdkifygonf? tpydkif;wGif omreftpm 0rf;rsm;oGm;+yD; yxrem&Dydkif;twGif;wGif ta&0rf; rsm;jym;vSpGm oGm;rnf? xdkta&0rf;onf qefaq;&nfuJhodk@qifwlaernf? tefjcif;ESifh (Adkufom;)=uGufwufjcif;a=umifh jyif;xefaomAdkufemjcif;udk jzpfaprnf?

a&m*gumuG,fjcif; usef;rma&;ESifhnDnGwfaom aumif;rGefaomoef@&Sif;r_(trd_uf ponf)/ oef@&Sif;pdwfcs&aoma&ay;a0r_/taxGaxGESifh wudk,fa& oef@&Sif;r_rsm;onf umv0rf;a&m*g jzpfyGm;jcif;rS umuG,fa&;twGuf toHk;;usygonf?wufx&mqdkufuvif;aq;udk umuG,faq;tjzpf0efxrf;rsm;ESifh a&m*gxdawG@r_&Sdolrsm;twGuf umv0rf;uyf a&m*gjzpfcsdefwGif toHk;jyKEdkifonf? (wufx&mqdkufuvif;ESifhudkx&dkifrdkZaZm onf umv0rf;a&m*gydk;wcsdK@udk rwdk;a=umif;aq;ynm*sme,ftcsd K @wGif awG@&Sd&onf)? umv0rf;a&m*gjzpfyGm;r_udk oufqdkifaom usef;rma&;t&m&Sdrsm;udk today; owif;ydk@yg/

t0wfpjzifh a&ppfjcif;onf umv0rf;a&m*gudk wm;qD;Ed kifrt0wfpjzifh a&ppfjcif;onf umv0rf;a&m*gudk wm;qD;Ed kifrt0wfpjzifh a&ppfjcif;onf umv0rf;a&m*gudk wm;qD;Ed kifrt0wfpjzifh a&ppfjcif;onf umv0rf;a&m*gudk wm;qD;Ed kifrt0wfpjzifh a&ppfjcif;onf umv0rf;a&m*gudk wm;qD;Ed kifrnfnfnfnfnfvm;vm;vm;vm;vm;

okawoDwdk@ qdkonfrSm csnfjzifh,ufvkyfxm;aom ydwft0wfpta[mif;jzifh a&tm; ppf+yD;oHk;v#if aus;&Gmrsm;&Sd umv0rf;a&m*gjzpfyGm;r_udk xuf0ufcef@ avsmhusapEdkifrnf?

?

ISSUE 24, JUNE, 2004 15

Transmission:The amoebae in the large intestines makemany cysts, which are passed in thestool. These cysts are infective ifswallowed. Direct faecal-oral spreadcan occur, but much more commonly,faeces with cysts contaminate food orwater. When the food or water isswallowed, the cysts develop intoamoebae in the intestine.

Signs and symptoms:Abdominal pain, vomiting and feveraccompanied by diarrhoea that can rangefrom watery stools to a dysentericsyndrome of bloody stools containingmucus and pus.

Prevention:Cases and carriers should not be allowedto handle food. They must wash theirhands after using the toilet. Use propertoilets, which do not contaminate waterand food. Cook food properly and keepfood covered.

Cholera:Causative organism is a bacterium (vibriocholerae). Many people do not developthe clinical signs or may have only a milddisease.

Transmission:Cholera organisms are passed from thegut (gastrointestinal tract) into the faecesor vomits. The organisms then spread tothe mouths of other people.

Contamination of food by contaminatedwater, hands, and flies, can also occur.

Signs and symptoms:In severe cases, this disease causes rapiddehydration (within hours), shock anddeath. After normal faeces, largeamounts of watery stools may pass inthe first few hours. Stools may look likeboiled rice water. Vomiting and crampscan cause severe abdominal pain.

Filtering Water in Cloth May Cut Cholera

Researchers say that simply filtering water through old cloth made of gauzelikecotton fabric may be good enough to reduce cholera cases by about half in rural villages.

Prevention:Good sanitation, safe water supply andgeneral hygiene will help prevent cholera.Tetracycline can be used as aprophylactic drug for staff and contactsduring a cholera epidemic. (Tetracyclineand Co-trimoxazole resistance has beenreported-Lancet 349:924, 1997; reviewLancet 349-1825, 1997). Report allsuspected cases of cholera to theconcerned Health Officer in your area.

Typhoid fever:The causative organism is a bacterium(salmonella typhi).

oef@&Sif;aoma&ay;pepf - Safe water supply

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wdkufzG d Kufac:tla&mifief;zsm;a&m*gwdkufzG d Kufac:tla&mifief;zsm;a&m*gwdkufzG d Kufac:tla&mifief;zsm;a&m*gwdkufzG d Kufac:tla&mifief;zsm;a&m*gwdkufzG d Kufac:tla&mifief;zsm;a&m*gwdkufzGdKuf ac: tla&mifief;zsm;a&m*gudk jzpfapaomydk;r$m;aumifrSm bufwD;&D;,m;ydk;wpfrsdK; (qmvrdkeJvmwdkifzD;) jzpfygonf?

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a&m*gumuG,fjcif;Ta&m*gjzpfyGm;aeaom vlemrsm;/ a&m*go,faqmifaomolrsm;udk tjcm;olrsm;twGuf tpm;taomufjyifqif&mwGif yg0ifvkyfaqmif&ef cGifhrjyKoifhyg? oef@&Sif;I pdwfcs&aomvlxka&ay;a0a&;/ pepfusaom rpifESifh qD;pGef@ypfa&;rsm;onf r&Sdrjzpf ta&;}uD;vSygonf? (tla&mifief;zsm;a&m*gumuG,faq; xdk;jcif;jzifhvnf; umuG,fEdkifygonf?)

tonf;a&miftom;0g trsd K;tpm;tonf;a&miftom;0g trsd K;tpm;tonf;a&miftom;0g trsd K;tpm;tonf;a&miftom;0g trsd K;tpm;tonf;a&miftom;0g trsd K;tpm;-----atatatatat

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EdkifiHrsm;wGif uav;b0uyif Ta&m*gydk; 0ifa&mufxm; wwf=ujyD; a&m*g+yD;aewwf=uygonf?

ul;pufjyef@yGm;yHkrpif - yg;pyfvrf;a=umif; odk@r[kwf tonf;a&miftom;0g trsdK;tpm; - atAdkif;&yfpfydk; yg0ifaeaomtpm;taomufrsm;udk pm;aomufrdjcif;jzifh a&m*gjyef@yGm;ul;pufEdkifygonf?

a&m*gvuQ%mrsm;yxrtywfwGiftzsm;tenf;i,fwufjcif;/ rtDromjzpfjcif;/ tpm;taomufysufjcif;/ tefjcif;/ 0rf; Adkuf.nmbuftay: (tonf;ae&m) t enf; i,f atmifhjcif; ponfwdk@ jzpfEdkifonf? yxr tywf aemufykdkif;wGifqD;ta&mif &ifhjcif;/ tom; 0gjcif; wdk@jzpfrnf?

a&m*gumuG,fjcif;oef@&Sif;Ipdwfcs&aoma&ay;a0jcif;ESifh pepfusaomoef@ &Sif;onfh ,ifvHktdrfomrsm;oHk;pGJjcif;?

tufpu&Da&;pp f (p)ac:oHvH k ;aumi fa&m*gr sm;tufpu&Da&;pp f (p)ac:oHvH k ;aumi fa&m*gr sm;tufpu&Da&;pp f (p)ac:oHvH k ;aumi fa&m*gr sm;tufpu&Da&;pp f (p)ac:oHvH k ;aumi fa&m*gr sm;tufpu&Da&;pp f (p)ac:oHvH k ;aumi fa&m*gr sm;(Ascariasis)

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tufpu&pf(p)ac: oHvHk;aumifa=umifh jzpfyGm;ygonf?t&G,fa&mufaom oHvHk;aumifrsm;.t&G,ftpm; rSm 15 rS 25 pifwDrDwmtxd &Snf+yD;vlem. tlodrfxJwGif rSDcdkaexdkifonf?

ul;pufjyef@yGm;yHkt&G,fa&mufaom oHvHk;aumiftrrS tlxJwGifaxmifaygif;rsm;pGmaom Orsm;udk Oonf? xdkOrsm;onf vlem rpifpGef@aomtcg rpifESifhtwlyg vmonf? xdkOrsm; onf pdkpGwfaomajr=uD;wGif &Sdaeygu2ywfcef@t=umwGiftjcm;vlrsm;udk tufpfum&Da&;ppfoHvHk;aumif a&m*g udkul;pufEdkifpGrf;&Sdonf?xdkOudk tnpfta=u;/ a& odk@r[kwf tpm;tpmrSwqifh rsdKcsrdygu ul;pufjyef@yGm;r_ jzpfapEdkifonf?uav;rsm; a&m*gydk;&Sdaeaom ajray:wGif upm;jcif;jzifh a&m*gul;pufavh&Sdygonf?

ISSUE 24, JUNE, 2004 17

TransmissionThe faeces or urine of an infected personmay contaminate food or drinking water.This may occur if they handle food, or ifthey do not use a proper toilet. It mayalso occur if the water supply is not safeor contaminated with excreta or is nottreated. Sometimes flies may carry thebacteria from faeces to food.

Signs and symptomsFirst week: general symptoms ofinfection; for example, malaise,headache, abdominal pain, constipationand fever.Second week: condition gets worse.Diarrhoea and rash of red spots may beseen.Third week: symptoms and signsbecome more severe. Patient maybecome unconscious and die.Perforation of intestines may be seen.Haemorrhage may occur in smallintestines.

PreventionPatients and carriers should not beallowed to handle food for others. Safecommunity water supply, proper disposalof faeces and urine is essential.Immunisation using typhoid vaccine mightbe recommended for health staff.

Hepatitis AThe causative organism is a virus (HAV-Hepatitis A Virus). Many people indeveloping countries have had HAVduring childhood and are immune.

TransmissionFaecal-oral route of transmission byingestion of contaminated food andwater.

Signs and symptomsFirst week - mild fever, malaise, loss ofappetite, vomiting and mild right upperabdominal pain (liver area). After firstweek: dark urine and jaundice (yellowskin).

PreventionProvide safe water supply and usesanitary type of latrines.

AscariasisIt is caused by a worm (ascaris orroundworm). Adult worms are about15 - 25 cm in length and live in the smallintestine.

TransmissionThe adult female worm lays thousandsof eggs in the intestine, which pass in thefaeces. Eggs become infective after twoweeks of incubation in damp soil.Transmission happens when an infectiveegg is swallowed from dirt, water orfood. Children playing in contaminatedsoil is a common cause of infection.

Signs and symptomsChildren are infected more often andmore severely than adults. There are noobvious signs and symptoms. If there aremany worms, mild diarrhoea, abdominal

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oefvHk;aumifa&m*g/ - Ascariasis


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Water-based diseases

ISSUE 24, JUNE, 2004 19

discomfort and distension may appear.In rare cases, it can cause intestinalobstruction or pneumonia and asthma iflarvae travel to the lungs.

PreventionSystematic burying of faeces if there isno latrine, good hygiene practices suchas washing hands before eating andpreparing food, regular deworming, useof sanitary type of latrines or safe buryingof stools, safe water supply and variousgood hygiene practices can prevent thedisease.

Water-based diseases

The cause of these diseases is the pathogenicagent in water, which is transmitted through skinpenetration. People who have no access tolatrines, and defecate without burying theirstools and do so near the water sources, areresponsible for these diseases.

HookwormAdult worms are about 1 cm in length.They live in the upper small intestine ofhumans. They are attached to theintestinal wall and suck blood and proteinfrom there. Infestation is very frequent inchildren and is very damaging to theirhealth as it can cause malnutrition andserve anaemia. A high rate of infestationhas also been found in women ofreproductive age. Anaemia is dangerousfor pregnant woman.

TransmissionIn moist soil, fertilised eggs develop intolarvae and pass through the skin.

Signs and symptomsAnaemia, tiredness and dizziness. All

migrants with anaemia can be assumed tohave hookworms and should be treated.In Maela Camp, pregnant women withhookworm in the second and thirdtrimester of pregnancy are given treatmentwith Mebendazole. But if a woman in thefirst trimester is found to be infected withhookworm, she can be treated at thebeginning of the second trimester.

PreventionUse of latrine or burying stools. If possible,use foot wear while walking on the ground.Regular deworming is necessary.

FlukesIn Maela Camp, (flukes) Paragonimuswestermani and opisthorchis have beenpositively identified in residents.

Water-related, vector-borne diseases

Water-related, vector-borne diseases includedengue fever, malaria and filariasis. Thetransmission of these diseases is more complexbecause it involves a host (a person or an animal),a pathogenic agent (a parasite or a virus) whichgives away the disease, and a vector usually amosquito that carries the pathogenic agent. Thevector is usually a mosquito..

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rl&if; - Source: TALC


rl&if; - Source: WHO

?o,faqmifxm;aom jcifaumif)rsm; yg0ifaoma=umifh jzpfonf?

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'i f* D ;'i f* D ;'i f* D ;'i f* D ;'i f* D ;wkyfauG;a&m*gwkyfauG;a&m*gwkyfauG;a&m*gwkyfauG;a&m*gwkyfauG;a&m*g'if*D;wkyfauG;a&m*gonff'if*D;wkyfauG; Adkif;&yfpfydk;a=umifh jzpfyGm;onf? uav;rsm;wGuf aoapEdkifaoma&m*gwpfckjzpfonf?

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a&m*gumuG,fjcif;umuG,fenf;rsm;rSm iSufzsm;a&m*gumuG,fenf;uJhodk@yif jzpfonf? tdrfywf0ef;usifw0dkuf&Sd jcifaygufyGm;&mae&mrsm;udk z,f&Sm;&Sif;vif;ypfyg? trd_ufrsm;udkajrjrKyfypfyg/ tb,fa=umifhqdkaomf xdkae&mrsm;onfjcifaygufyGm;&mae&mrsm; jzpfEdkifaoma=umifh jzpfonf?a&xnfhaomyHk;rsm;/ tdk;rsm;udk tzHk;tumjzifh zHk;tkyfxm;yg?

(((((qifqifqifqifqif}uD;)qif}uD;)qif}uD;)qif}uD;)qif}uD;)qifajcaxmufajcaxmufajcaxmufajcaxmufajcaxmuf a&m*ga&m*ga&m*ga&m*ga&m*g (Filariasis)

tyfcsnfr#ifuJhodk@aom oHaumifrsdK;rsm;(zDav;&D;,m;)a=umifh jzpfyGm;aponf? ToHaumifrsm;onf vifh

ISSUE 24, JUNE, 2004 21

MalariaIt is caused by protozoa.

TransmissionMosquitoes are infected by sucking upthe blood of an infected person. Afterdevelopment in the midgut of themosquito, sporozoites can be transmittedto another person through the bite of afemale mosquito (Anopheles). Themosquito usually bites at dawn and dusk.The Anopheles mosquito likes the forestand mountain areas including coastalmangroves.

Signs and symptomsUsually begins with a few days of vagueill health. Then attacks of fever occur withchills and heavy sweating occursfollowed by headache, vomiting,delirium. Attacks are usually repeatedduring several days. Then the diseaseleads to a chronic stage that may lastyears before the patient developsimmunity. Fully developed immunity israre in areas of low transmission like mostof South-East Asia but common in highertransmission areas of Sub-SaharanAfrica.

PreventionProtection from mosquito bites. Use ofbed nets and covering the skin with longsleeves and trousers. Eliminate mosquitobreeding grounds.

Dengue fever:The causative organism is dengue virus.This disease is one of the killer diseasesof children.

TransmissionThis disease is transmitted by the bite of

the Aedes aegypti mosquito. Aedesmosquito is a day biter and lives aroundthe house and breeds in water containerssuch as old discarded tires and coconutshells. Dengue is an epidemic diseasecausing an increased number of cases atcertain periods of the year, usually duringthe rainy season. An outbreak can beexperienced every two to three years.

Signs and symptomsClients may or may not have symptoms.It usually starts with fever and headache.Then the headache worsens with severejoint and back pains. Usually there arerashes on the skin. The disease can leadto haemorrhagic fever. Bleeding spotsmay appear on the skin. It can lead toshock and even death.

PreventionPreventive measures are more or less likemalaria prevention. Eliminate all breedingsites around the house. Bury the rubbishbecause it can become breeding sites.Keep all water containers covered.

Filariasis - qif}uD;a&m*g

rl&if; Source: WHO

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qDodk@ vufacsmif;rsm;/ rsufESmokwfyk0grsm;/ vl@toHk;taqmifypPnf;rsm;rSwqifh a&mufoGm;ygu ul;pufjyef@yGm;Edkifygonf? ,ifaumifrsm;onf Ta&m*gydk;o,faqmifjyef@yGm;ap&mwGif tifrwefrS ta&;=uD;aom tydkif;rS yg0ifaeonf?

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0Ja&m*g 0Ja&m*g 0Ja&m*g 0Ja&m*g 0Ja&m*g (((((Scabies)))))

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rsufcrf;pyfa&m*grsufcrf;pyfa&m*grsufcrf;pyfa&m*grsufcrf;pyfa&m*grsufcrf;pyfa&m*gemwm&Snfrsufpdemjcif;wpfrsdK;jzpfonf? uvdkufrdkif'D;,m;ydk; a=umifh rsufpdtarS;yg;a&mifjcif; jzpfonf?a&m*gjzpf+yD; =um&SnfpGm aq;ukor_r jyKvkyfygursufpduef;oGm; Edkifygonf?

ul;pufjyef@yGm;yHkrsufcrf;pyfa&m*gydk;&Sdaeaomvlem. rsufpdrSxGufaomt&mrsm; (rsufacs;ponf) aemufvl wpfa,muf

rl&if; - Source: TALC

avS;a=umifhjzpfyGm;aponf? xdkavS;rsm;onf ta&jym;udk xdk;azguf0ifa&muf+yD; Orsm;Ocsonf?

ul;pufjyef@yGm;yHk0Ja&m*g&SdaomvlemESifh eD;uyfxdawG@ aexdkifjcif; / vlem.t0wftpm;rsm;udk ,lI 0wfqifjcif;rsm;onf0Ja&m*gudk vG,fulpGm ul;pufaponf? T0Ja&m*gonftdrfwGif wpfa,mufjzpfygu tdrf&dStwlaetdrfom;rsm;tm;vkHk;udk ul;pufjyef@yGm;avh&Sdonf?

a&m*gvuQ%mrsm;0Ja&m*gydk;&Sdaomae&mrsm;wGif ,m;,Hjcif;jzpfrnf/vufz0g;ESifhajcz0g;. ta&jym;ay:wGif ao;i,faomcsdKifhcGufuav;rsm; ay:vmrnf/ a&m*gjzpfyGm;aomae

ISSUE 24, JUNE, 2004 23

Filariasis is caused by one of severaldifferent types of thread-like worms (filaria).The worms live in the lymph nodes. It isone of the causes of disability in the tropics.

TransmissionLarvae of the worms are transmitted topatients through the mosquito bite.

Signs and symptomsSome infected people may not show signsand symptoms for years. Filariasis maypresent with fever and inflammation ofthe lymph vessels and/or lymph nodes.The most obvious signs may appear aftermany years, showing chronic oedema ofsome parts of the body (limbs, scrotum,breast) and is called elephantiasis.

PreventionMosquito control and personalprotection from mosquito bites withclothing, repellents and mosquito nets arehelpful. Mass treatment in endemic areasis recommended.

Water-washed diseases

Sufficient amounts of water usage such ascleaning, washing, bathing and hygienicpractices of the community can prevent water-washed diseases.

TrachomaA chronic form of conjunctivitis, which isa chlamydia infection of the conjunctiva.If not treated properly, it can causeblindness over time.

Transmission:It happens when an eye discharge froman infected person is passed on toanother through fingers, towels and

personal effects. Flies are probably veryimportant in spreading the infection.

Signs and symptomsIt begins with red and watery eyes(ordinary conjunctivitis). After a monthor so, small pinkish-gray lumps can forminside the upper eyelid. Pus may be seenon the affected eyelid.

PreventionGood Hygiene and regular washing ofthe face and hands with soap and watercan prevent this infectious disease.

ScabiesThe causative organism is a mite, whichpenetrates the skin to lay eggs.

TransmissionThis disease can be contracted throughclose contact with infected persons andusing clothing of infected persons. Itusually infests all the people living in thesame house.

Signs and symptomsThe infected body parts are itchy and

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rsufcrf;pyf/ Trachoma rl&if; - Source: TALC


a&/ oef@&Sif;a&;ESif hqufEG,faoma&m*grsm; umuG,fwm;qD;jcif;a&/ oef@&Sif;a&;ESif hqufEG,faoma&m*grsm; umuG,fwm;qD;jcif;a&/ oef@&Sif;a&;ESif hqufEG,faoma&m*grsm; umuG,fwm;qD;jcif;a&/ oef@&Sif;a&;ESif hqufEG,faoma&m*grsm; umuG,fwm;qD;jcif;a&/ oef@&Sif;a&;ESif hqufEG,faoma&m*grsm; umuG,fwm;qD;jcif;

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• vlrsm;onf a&m*gydk;o,faqmifaomtaumif rsm;ESifhqufEG,faom a&m*grsm;ta=umif;udk odap&rnf/xdka&m*grsm;udk rnf uJhodk@umuG,fwm;qD;&rnfudkvnf; od&Sd+yD; vdkufem jyKrlusifh}uHap&rnf?

rl&if;/ uGif;x&ef

?&mrsm;rSm vufacsmif;rsm;/ vufarmif;rsm;/ vufaumuf0wfrsm;/ wawmifqpfauG;rsm;ESifh aygifjcHrsm;jzpf=uonf? rsm;aomtm;jzifh rsufESmudk rxdcdkufyg?

a&m*gumuG,fjcif; -wpfudk,fa&oef@&Sif;jcif;ESifh rSefrSeft0wfrsm;av#mfjcif;onf T0Ja&m*gudk tumtuG,fay;ygvdrfhrnf?a&vHkavmufpGm&&Sdaom ae&mrsm;ESifh t0wfrsm;udkrSefrSefav#mfzGwfaom vlxktwGif;wGif T0Ja&m*g jzpfyGm;jcif; &Sm;yg;vSygonf?

a&ESifhqufEG,faom a&m*grsm;udkumuG,fjcif;

txufwGifaz: jycJhaoma&m*grsm;tm;vHk;udk rjzpfatmif umuG,fwm;qD;Edkifygonf? Ta&m*grsm;udkumuG,fwm;qD;&ef usef;rma&;ESifhnDnGwfaomoef@&Sif;r_ (Hygiene) [laom pum;vHk;rsm;jzifh umuG,fwm;qD; Edkifygonf? wenf;tm;jzifhqdkaomf a&rsm;udkaumif;rGefpepfuspGm oHk;pJGjcif;/ tpmrsm;udk aumif;rGefoef@&Sif;pGm jyifqifjcif;/ rpifrsm;udk pepfuspGm pGef@ypfjcif;/ usef;rma&;ESifhnDnGwfaom tjyKtrl aexdkifyHkudkvdkufemjcif; ponfwkd@ jzpfygonf?

umuG,fwm;qD;jcif;a&m*gjzpfyGm;apaomydk;r$m;aumifrsm;onf vl.udk,fcE<mtwGif;odk@ vrf;a=umif;aygif;pHkjzifh 0ifa&mufvmEdkifygonf? ody Henf;ususajym&v#if a&m*gul;pufenf;vrf;a=umif;rsm; jzpfygonf? rpif-yg;pyfa&m*grsm;rSm

ul;pufenf;vrf;aygif;rsm;pGm &Sdonf? Oyrm -vufacsmif;rsm;/ tpm;tpmrsm;/ ta&rsm;/ ,ifaumifrsm;ESifh rpifrSyg;pyfxJodk@ ponfwdk@ jzpfygonf?a&rSwqifh o,faqmifaoma&m*grsm;/ a&udktajcjyKI jzpfvmaoma&m*grsm;ESifh a&ESifhqufEG,fI ydk;r$m;rSwqifh o,faqmifvmaoma&m*grsm;twGufwm;qD;umuG,f&ef ul;pufenf;vrf;a=umif;rsm;udkjzwfypfjcif;jzifh wm;qD;Edkifygonf? Oyrmtm;jzifh -vlrsm;onf vufrsm;udkrSefrSefaq;a=umjcif;/ tpm;taomufrsm;udk aumif;rGefpGm usufatmifcsufjyKwfjcif;/ aomufa&udk }udKcsufjcif;/ ponfwdk@onf a&ESifhquf EG,faoma&m*grsm;. ul;pufvrf;a=umif;rsm;udkjzwfawmufjcif;jzpf+yD; a&ESifhqufEG,faom a&m*grsm;tm;vHk; jzpfyGm;jcif;rS umuG,fwm;qD;Edkifrnf jzpfonf?iSufzsm;ydk;o,faqmifaom taemzdvdjcifudkufjcif;qdkaom ul;pufvrf;a=umif;wpfrsdK;udk jzwfawmuf&efvlrsm;onf jcifaxmifjzifhtdyfygu iSufzsm;udk umuG,fwm;qD; Edkifygrnf?a&rvHkavmufojzihf&aoma&m*g twGuf (0Ja&m*g)umuG,fwm;qD; &ef vlrsm; onf a&oHk;I t0wfrSefrSefav#mfjcif;jzif h avS;rsm; vlwpfa,mufrSaemufwpfa,mufodk@ o,faqmif jyef@ES H @ jcif;rSumuG,fEdkifrnfjzpfonf?txufygwifjycJhaom Oyrmrsm;udk =unfhjcif;tm;jzifha&m*grsm;umuG,fwm;qD;&efrSm usef;rma&;ESifh nDnGwfaom tjyKtrl/ aexdkifyHkudk vkdufem&efjzpfygonf?

ISSUE 24, JUNE, 2004 25

small skin burrow lesions usually appearon the web of the hands and feet. Theaffected body areas are the fingers, arms,wrists, elbows and the pubic (lower partof the trunk) region. The face is notaffected in most cases.

PreventionGood personal hygiene and regularwashing will prevent this disease.Scabies rarely affect communities wheresufficient quantities of water are availableand people wash regularly.

Prevention of water-related diseases

All the above-mentioned diseases arepreventable through, proper hygiene. In otherwords, good practices in water usage, foodpreparation, faeces disposal, healthybehaviours and life-styles are necessary.

PreventionA pathogenic agent can enter the bodythrough various pathways or more

scientifically, the transmission routes.Faecal-oral diseases have varioustransmission routes such as from fingers,foods, fluids, flies and faeces to mouth.For water borne, water-based andwater-related, vector-borne diseases,prevention can be done by breakingtransmission routes. For example, ifpeople wash hands regularly, cook foodthoroughly, and boil drinking water, thetransmission routes of certain waterrelated diseases will be cut and thesediseases will be prevented.If people sleep under a bednet to cut thetransmission route (i.e. to prevent a bitefrom the malaria vector anophelesmosquito), it will prevent malaria.For water-washed diseases, to avoidscabies, people should use water to washregularly and that will prevent the mite fromspreading from one to another.Again it is easy to see from the aboveexamples that following hygienic practicesand adopting the appropriate life stylesand behaviours will prevent diseases.

Prevention of Water and Sanitation-Related Diseases

• Make sure that people have access to an adequate quantity and quality of water inorder for them to practice proper personal and household hygiene. This may requireimproving the water supply system.

• Make sure people have access to properly built latrines and know the importance ofusing the latrine every time they defecate and practice it.

• Set up a water supply system for people to wash so that they do not need to enter alake or pond, which will increases their chance of getting infected.

• Make sure that people are aware of the importance of good personal and householdhygiene and make sure that they are practicing it, as well.

• Make sure that people are aware of vector-related diseases, and that they know andpractice ways to prevent them from contracting the diseases.

Source: Quyen Tran

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2) 0rf;av#m0rf;ysufa&m*gbma=umifht‡&m,f&SdovJ2) 0rf;av#m0rf;ysufa&m*gbma=umifht‡&m,f&SdovJ2) 0rf;av#m0rf;ysufa&m*gbma=umifht‡&m,f&SdovJ2) 0rf;av#m0rf;ysufa&m*gbma=umifht‡&m,f&SdovJ2) 0rf;av#m0rf;ysufa&m*gbma=umifht‡&m,f&SdovJ

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0rf;av#m0rf;ysufa&m*gonf tjzpfrsm;aom a&m*gjzpfonf? uav;aygif;ajrmufrsm;pGmonf tqdkyg 0rf;av#ma&m*ga=umifh ESpfpOfaoqHk;ae=uonf? txl;ojzifh touf 5ESpfatmufuav;rsm;twGufydkrdktEWWWWW&m,f

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rl&if; - Source: WEAVE

ISSUE 24, JUNE, 2004 27

Practical Guidelines for DiarrhoeaHealth Messenger Team

1. What is diarrhoea?

Three or more loose or watering stoolspassed in a day is defined as diarrhoea. Thereare two types of diarrhoea, classified as acuteand chronic. Acute diarrhoea starts suddenly,and may continue for several days. It is causedby infection of the bowel. Chronic diarrhoea isdiarrhoea that lasts for more than two weeks.

2. Why is diarrhoea dangerous?

Diarrhoea is dangerous as it can causeunder-nutrition and death.

Death from acute diarrhoea or dysentery(bloody diarrhoea) is most often caused by lossof a large amount of water and salts from thebody. This loss is called dehydration andelectrolytes (components of salt) imbalance.Diarrhoea is more serious in people who areundernourished. It can make under-nutritionworse. During diarrhoea, nutrients are lost fromthe body and a mother may not feed a child,who has diarrhoea. Appropriate food shouldbe given to children who have diarrhoea, assoon as they can eat.

3. How does diarrhoea cause dehydration?

The body normally takes in the water andsalts it needs through drinks and food (intake).It normally loses water and salts through faeces,urine and sweat (output).

When the bowel is healthy, water and salts

Diarrhoea is common. Many children die from it every year and it is especiallydangerous in children under 5 years of age. Fortunately, we can prevent diarrhoea.

If you treat children with diarrhoea carefully, very few of them will die.

pass from the bowel into the blood and the bodycan use these water and salts. When there isdiarrhoea, the bowel does not work normally.Less water and salts pass into the blood, and morepass from the blood into the bowel. Therefore,more than the normal amounts of water and saltsare passed out of the body in the faecal matter.

This larger than normal loss of water andsalts from the body results in dehydration. Itoccurs when the output of water and salts isgreater than the intake. Dehydration can bemade worse by vomiting, which oftenaccompanies diarrhoea.

Dehydration occurs faster in infants andyoung children, in hot climates, and when aperson has a fever.

4. What are the most important factors inthe treatment of diarrhoea?

The most important factors in the treatmentof diarrhoea are:

••••• to prevent dehydration from occurring;- Dehydration can usually be prevented

at home if the client drinks more fluidsthan usual as soon as diarrhoea starts.Food-based fluids, for example, gruel,soup, or rice water, can be used. Thefluids recommended for prevention ofdehydration at home will depend on:a. the availability of a suitable food- based fluid;b. the availability of salt and sugar;


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ISSUE 24, JUNE, 2004 29

c. the access of local people to health services; andd. availability of oral rehydration salts (ORS)

••••• to treat dehydration quickly and well ifit does occur;- If dehydration occurs, the client should

be taken to a community health workeror health center for treatment. The besttreatment for dehydration is oral therapywith a solution made with oralrehydration salts (ORS). For treating

dehydration, ORS should always beused, whenever possible.

••••• to feed the client.- While the client is ill with diarrhoea, he

or she should be offered small amountsof nutritious, easily digestible food. Theextra fluids given to the client do notreplace the need for food. Afterdiarrhoea has stopped, an extra mealeach day for a week will help the childregain the weight lost during the illness.

According to UNICEF, diarrhoea diseases claim the lives of around two million childreneach year - 5,000 per day, and cause countless more to fall ill. Children already sufferingfrom poor diet and the ravages of other diseases are the first to get sick and die from waterand sanitation-related diseases such as diarrhoea, cholera and typhoid.

NEW YORK, 19 March 2004


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ISSUE 24, JUNE, 2004 31

5. How will you assess a client who has diarrhoea?

The health worker should ask, look, feel for signs of dehydration, and check for problemsother than dehydration.

••••• Ask the following questions:

- How many liquid stools per day has the client been passing?How long has the client had diarrhoea?Is there blood (more than 1 or 2 streaks) in the faeces?

- Has the client been vomiting?If so, has the client vomited more than a small amount?How frequently has the client vomited?

- Is the client able to drink?If so, is the client thirstier than usual?

- Has the client passed urine in the last 6 hours?If so, is it a normal amount or a small amount?Is it darker than usual?

••••• Look for the following conditions:

- What is the client ‘s general condition?- Is the client

(a) well and alert?(b) unwell, sleepy, or irritable?(c) very sleepy, floppy, or unconscious?(d) having fits?(e) severely under-nourished (wasting or thinness)?

- Does the client have tears when he or she cries?- Are the client’s eyes normal, sunken, or very dry and sunken?- Are the client’s mouth and tongue wet, dry, or very dry?- Is the client’s breathing normal, faster than normal, or very fast and deep?

••••• Feel for the signs:

- When the skin is pinched, does it go back quickly, slowly, or very slowly (longer than 2seconds)? In a baby, you should pinch the skin of the abdomen or thigh. (Rememberthat pinching may give misleading information if a child is either undernourished or obese,and also for very old clients who have lost skin elasticity)(a) In a severely undernourished child, the skin may go back slowly, even if the child isnot dehydrated.(b) In an obese child, the skin may go back quickly even if he or she is dehydrated.(c) In a very old person with loss of elasticity, skin may not go back at all times.

- Can the pulse be felt?If so, is it normal, faster than normal, very fast, or weak?

- Is fontanelle (the soft spot on top of the head of infants) normal, sunken, or very sunken(usually children under 12 months old)?


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ISSUE 24, JUNE, 2004 33

••••• Check body weight and temperature

Body weight- If a scale is available, carefully take the weight of the client lightly clothed.Compare the client’s present weight with the last recorded weight. Loss of fluid causes lossof weight. However, it is more useful to rely on clinical signs than on measuring weight lossto make a judgement about the dehydration.

Temperature- Does the client have a fever (a temperature of more than 38.5 C)?Rectal temperature should be taken if the health worker is used to that procedure.Otherwise, the axillary (armpit) temperature should be taken.

OTHER PROBLEMS

• DIARRHOEA LONGER THAN 14 DAYS DURATION, BLOOD IN THE STOOLSAND SEVERE MALNUTRION SHOULD BE REFERRED TO PHYSICIAN.

• FEVER 38.5 C (OR 101ºF) OR GREATER: TEACH THE MOTHER HOW TOCOOL THE CHILD AND LOOK FOR AND TREAT OTHER CAUSES (FOREXAMPLE, PNEUMONIA, MALARIA ).

Assessment for dehydration

1. ASK ABOUT DIARRHOEAVOMITINGTHIRSTURINE

2. LOOK AT CONDITION

TEARSEYESMOUTH andTONGUEBREATHING

3. FEEL SKINPULSE

FONTANELLE(for infant)

4. TAKE TEMPERATURE

5. WEIGH IF POSSIBLE

6. DECIDE

less than 4 liquid stools/ dayNone or small amountNormalNormal

4 to 10 liquid stools/ daySomeGreater than normalA small amount and dark

More than 10 liquid stools/dayVery frequentUnable to drinkNo urine for 6 hours

Well alert

PresentNormalWet

Normal

Unwell, sleepy or irritable

AbsentSunkenDry

Faster than normal

Very sleepy, unconscious,floppy or having fitsAbsentVery dry and sunkenVery dry

Very fast and deep

A pinch goes back quicklyNormal

Normal

A pinch goes back slowlyFaster than normal

Sunken

A pinch goes back veryslowly, very fast, weak or youcannot feel itVery sunken

Loss of less than 25 gramsfor each kg. of weight

Loss of 25 - 100 gramsfor each kg. of weight

Loss of more than 100 gramsfor each kg. of weight.

The client has no signs ofdehydration

If the client has 2 or moreof these signs, he has somedehydration

If the patient has 2 or moreof these danger signs, he hassevere dehydration


0rf;av#m0rf;ysufa&m*gtwGuf aq;ukor_ vrf;n$efcsufrsm;

tdrfwGifukor_ay;yg

0rf;av#m0rf;ysuf(2ywfxufydkjzpfjcif;)odk@r[kwf 0rf;udkufjcif;(0rf;xJwGifaoG;yg jci f ;)od k @r[kwf ta&raomufEdkifjcif; odk@r[kwf ta&jym;e*dkae&modk@ jyefa&muf&ef tcsdefodyf=umjcif;

ta&ud ktir f ;r&aomuf jci f ;odk@r[kwf ta&jym;e*d kae&modk@jyefa&muf&eftcsdef=umjcif;

ta&udk yHkrSeftwdkif;aomufjcif;odk@r[kwf ta&jym;e*d kae&modk@jyefa&mufr_ yHkrSefjzpfjcif;

aq;&kHodk@ta&;ay:v$Jay;yg ta&cef;ajcmufjcif;tcsKd@ "gwfqm;xkwf (ORS)jzifh ukoyg?tdrfwGifukor_ay;yg

ORS uav;.touf

4 vtxd 4 - 12 v 12 v - 2 ESpf 2 ESpf-5ESpf

rDvDvDwm 200-400 400-700 700-900 900-1400

cGufjzifh 2 cGuf 3-4 cGuf 5-6 cGuf 6-8 cGuf

t dr fw Gi f jy Kp ku koay; jci f ;t dr fw Gi f jy Kp ku koay; jci f ;t dr fw Gi f jy Kp ku koay; jci f ;t dr fw Gi f jy Kp ku koay; jci f ;t dr fw Gi f jy Kp ku koay; jci f ;

r dci fu d k a jym jyy gr dci fu d k a jym jyy gr dci fu d k a jym jyy gr dci fu d k a jym jyy gr dci fu d k a jym jyy g

1) tydkt&nfrsm;wdkufyg(uav;aomufEdkifoavmuf)/Oyrm/ Edk@/ 'defcJ a&/ xrif;a&/ [if;oD;[if;&GufpGyfjyKwf/opfoD;azsmf&nf/ &kd;&dk;oef@&Sif;aoma& (odk@r[kwftjcm;&Edkifaomta&rsm;/ Oyrm-qefjyKwf)

2) rdcifEdk@udk c%c%wdkufay;yg?

3) 0rf;wpfcgoGm;+yD;wdkif; rdcifudk cgwdkif; wdkufaeust&nftjyift&nfrnfr# wdkuf&rnfudk oifjyyg/

touf 2 ESpftxd- cGufwpf0uf/ uav;uydkawmif;ygu ydkwdkufEdkifonf/2 ESpftxuf- cGuftjynfh/ uav;uydkawmif;ygu ydkwdkufEdkifonf/

4) tpm;tpmrsm;udkcgwdkif;vdkqufau|;yg?

5) rdcifudk b,ftcg usef;rma&;Xmeodk@jyefvm&rnfudkrSmyg- uav;u t&nfraomufEdkifonfhtcg odk@r[kwf Edk@rpdk@Edkifonfhtcg/- uav;ydkIaeraumif;jzpfvmaomtcg- 0rf;xJwGifaoG;ygvmaomtcg/- uav;ut&nfaumif;aumif; raomufaomtcg

udk;um;csuf1? &kwfw&uf&ufwdkwdk 0rf;av#m0rf;ysufa&m*gjyKpkukor_ESifh umuG,fwm;qD;jcif;-vufawG@vrf;n$efcsufrsm;/ 'kwd,t=udrfyHkESdyfjcif;/ urBmhusef;rma&; tzGJ@csKyf/*sDeDAm?2? a&v$rf;rdk;aoma'owGif 5ESpfatmuf aeraumif; aomuav;rsm;tm;jyK pkapmifha&Smufukor_/ urBmhusef;rma&; tzGJ@csKyf/ ta&S‡awmiftm&Sa'o&Hk;?

• uav;onftxufZ,m;wGifjyxm;onf xuf ORS udkxyfawmif;ygu xyfay;yg/• Edk@rwdkufaom 6v atmufi,faom uav;i,frsm;twGuf yxr 4 em&DwGif ORS tjyifoef@&Sif;aom &dk;&dk;a&100-200 rDvDvDwmwdkufyg?

=> rdcifudk ORS b,fvdkwdkuf&rnfudk oifjyyg/• cGufxJrSt&nfudk wiHkpDc%c%wdkufyg/ uav;i,frsm;twGuf wpfrdepfwdkif; vbuf&nfZGef; 1 ZGef;wdkufyg?• uav;i,ftefygu 10rdepfapmifhyg/ qufvufI ydkjznf;nSif;pGm ORS udkwdkufyg/• uav;awmif;qdkygu rdcifEdk@udk qufwdkufyg/

=> 4 em&D=um+yD;aomtcg -• uav;tajctaeudkjyefppfaq;yg/• uav;udktpm;tpmau|;yg/

rdcifudkt}uHay;yg

ta&"gwfcef;ajcmufjcif;twGuf "gwfqm;&nf (ORS)

rnfr#vdktyfrnfudk wGufcsufyg?yxr 4 em&DtwGif;wGif ay;&rnfhyrm%

5ESpfatmufuav;rsm;twGuf 0rf;av#m0rf;ysufa&m*g ukor_

ISSUE 24, JUNE, 2004 35

DETERMINE THE AMOUNT OF ORS FORTREATMENT OF DEHYDRATION AND HOW MUCH ORS TO GIVE DURING

THE FIRST 4 HOURS

TREATMENT INSTRUCTIONS FOR DIARRHOEA

Provide Home Care

Persistent diarrhoea (morethan 2 weeks)orDysentery (blood in stools)orNot able to drinkorVery slow skin pinch

Drinks eagerlyorSlow skin pinch

Drinks normallyorNormal skin pinch

Refer urgently to hospital Treat some dehydrationwith ORSProvide Home Care

CARE FOR CHILDREN UNDER 5 YEARS OF AGE

ADVISE THE MOTHER

• If the child wants more ORS than the amountshown in the table, give more.• For infants under 6 months who are not breast-fed,also give them 100-200 ml plain clean water in additionto ORS during the first 4 hours.

=> SHOW THE MOTHER HOW TO GIVE ORSSOLUTION• Give frequent small sips from a cup. For smallinfants, tell the mother to give one teaspoon everyminute.• If the child vomits, wait for 10 minutes. Thencontinue giving ORS, but more slowly.• Continue breast-feeding whenever the child wants.

=> AFTER 4 HOURS• Reassess the child• Begin feeding the child

ORS AGE OF CHILD

Up to 4 - 12 12 months 2yrs. up4 months months up to 2 yrs to 5 years

in ml 200-400 400-700 700-900 900-1400

in cups 2 cups 3-4 cups 5-6 cups 6-8 cups

HOME CARE

TELL THE MOTHER

1. Give extra fluids (as much as the child can take)such as: ORS, milk, yoghurt drink, rice, watervegetable soup, fruit juice, plain clean water (orother locally available fluids e.g. boiled rice)

2. Breast-feed frequently

3. Show the mother how much fluid to give after eachstool in addition to the usual fluid intake:

Up to 2 years- half cup. Give more if the child wants more.

2 years or more- full cup. Give more if the child wants more.

4. Continue feeding

5. When to return. Tell the mother to return to thehealth worker if:- the child is not able to drink or breast-feed;- the child becomes sicker;- there is blood in the stool;- the child is drinking poorly.

Source:

1. The Treatment and Prevention of Acute Diarrhoea,Practical Guidelines, 2nd edition, WHO, Geneva.2. Management of Sick Children Under Five Years Age inFlood Affected Areas, WHO, SEARO.


oifhav#mfaomenf;jzifh tnpfta=u;rsm;pGef@ ypfjcif;tJvpfpbuf tDrmpef/ urBmhusef;rma&;tzGJ@

[email protected];pufa&m*g. t&if;tjrpfjzpfonf? tqdkyg rpifudk tEWWWWW&m,fuif;pGm pGef@ypfEdkifa&;onfywf0ef;usif oef@&Sif;a&;twGuf ta&;ygaom tcsufwcsufjzpfonf? Taqmif;yg;wGif ywf0ef;usiftajc

taetrsdK;rsdK;wdk@tvdkuf trsdK;tpm;rwlaom rpifpGef@ypf&eftdrfomrsm;ta=umif;udk wifjyxm;onf?

tnpfta=u;rsm;udk pepfwus pGef@ypfjcif;r&Sdv#ifajr}uD;ESifh a&t&if;tjrpfrsm;udk npfnrf;aponf? xdk@tjyif tnpfta=u;rsm;&Sdaomae&mrsm;Y ,ifaumifrsm;/jcifaumifrsm; aygufyGm;&mae&mvnf; jzpfwwfonf? Orsm;OcsI taumifrsm;wdk;yGm;vm+yD; a&m*grsm;tm; jyef@yGm;aponf? tnpfta=u;rsm;onf tdrfarG;owW0grsm;ESifh=uGufrsm;udkvnf; taxmufuljyKI a&m*grsm;udk jzpfay:aponf? xdk@tjyif qdk;&Gm;eHapmfaom teH@toufESifh tjrif

raumif;aomywf0ef;usif tajctaeudk jzpfay:aponf?bufwD;&D;,m;rsm;/ uyfyg;aumifrsm;ESifh oHaumifrsm;

tnpfta=u;rsm;wGif aeI a&m*grsm;udk jzpfay:aponf?Oyrm - 0rf;av#ma&m*grsm;/ tlvrf;a=umif;&Sd uyfyg;a&m*grsm;/ toJa&mifa&m*gESifh tla&mifief;zsm;a&m*gwdk@jzpfonf? tlvrf;a=umif;&SdoHaumifa&m*grsm; (csdwfoHaumifESifh tjcm;oHaumifrsm;)onf a&m*g&Sdol.rpifESifhxdawG@onfh ajr}uD;rSwqifh a&m*gul; pufjcif; jzpfonf?

euf&d_if;aom ajrmif;tdrfom - Deep trench latrine

tumt&H

tenf;qHk; 50 pifwDrDwm

vufaq;a&

a&pkyfusif;

t0if

txGuf

qifhwef;

(rl&if; - Source: WHO)

tqif;

ISSUE 24, JUNE, 2004 37

Appropriate Disposal of ExcretaElisabeth Emerson,WHO

Improper disposal of excreta contaminatessoil and water sources. It can serve as abreeding ground for certain species of flies andmosquitoes, giving them the opportunity to laytheir eggs and multiply or to feed and transmitthe infection. It also attracts domestic animalsand rodents, who carry faecal matter on themand with it, potential diseases. Furthermore, thissituation usually creates unsightly areas anddisagreeable odors.

Bacteria, parasites, and worms that live inexcrement cause diseases, such as diarrhealdiseases, intestinal parasitic infestations,hepatitis, and typhoid fever. Intestinal worminfestations (hookworm and others) aretransmitted through contact with soilcontaminated with faeces and may spreadrapidly where open defecation occurs andpeople are barefoot. The microorganisms

contained in human faeces may enter the bodythrough contaminated food, water, eating andcooking utensils and by contact withcontaminated objects. Use of sanitationservices protects health, prevents disease, andprotects surface and ground water.

The goal of sanitary excreta disposal is toisolate excrement, so the infectious agents in itcannot reach a new host. The method selectedfor a given area or region will depend on many

Human excreta waste is a source of infection. Safe removal and disposal of humanexcreta is an important part of environmental sanitation. This article highlights the

different kinds of latrines for disposal of excreta in varying situations.

wdrfaomajrmif;tdrfom - Shallow trench latrine

25 pifwD rDwm

75 p

ifwDrDw

m



ajr}uD;ay: wGifrpifpGef@jcif;ESifhtqdkygajr}uD;tm; zdeyfrpD;aomolrsm;rSwqifha&m*gjyef@yGm;Edkifonf? vlwdk@. rpifwGifyg0ifonfh a&m*gydk;rsm;onf cE<mudk,ftwGif;odk@ tpm;taomufrsm;/ a&rsm;/ csufjyKwfonfh tdk;cGufrsm;/ pm;oHk;onfh yefuefrsm;rSwqifh 0ifa&mufEdkifonf?

ywf0ef;usifoef@&Sif;a&;enf;pepfudk toHk;jyKjcif;tm;jzifh usef;rma&;aumif;rGefapjcif;/ a&m*grsm;tm; umuG,fjcif;ESifh ajray:ESifh ajratmufa&rsm;udk npfnrf;jcif;rSvnf;umuG,fay;onf?

tdr fomwnfaqmufjci f;tdr fomwnfaqmufjci f;tdr fomwnfaqmufjci f;tdr fomwnfaqmufjci f;tdr fomwnfaqmufjci f;

ywf0ef;usifoef@&Sif;a&; 0efaqmifr_vkyfief;r&Sdv#iftdrfomrsm;udk wnfaqmufoifhonf? atmufyguJhodk@rwlnDaomtajctaersm;wGif tdrfom trsKd;tpm;oHk;rsKd;/wnfaqmufEdkifonf?

wdrfaom ajrmif;tdrfomtnpfta=u;rsm;udk pGef@ypf&mwGif ,m,Dtm;jzifh

wdrfaomajrmif;tdrfomudk toHk;jyKEdkifonf? tqdkyg wdrfaomajrmif;tdrfomudk wygwf(7 &uf)xuf ydkI toHk;rjyKoifhay? tqdkygajrmif;tdrfomtm; wygwfrjynfhv#ifajr}uD;ESifhzHk;+yD; aemufxyfae&mwck ajymif;ay;oifhonf?vlxktaejzifh trsm;oHk; ajrmif;tdrfom oHk;&ef oifhroifhqHk;jzwfoifhonf? 3 rDwmrS 5 rDwm tuGmta0;&Sdwdrfaomajrmif;tdrfom wvHk;udk vl 100 cef@ oHk;pGJEdkifonf? ajrmif;tdrfomudk toHk;jyKygu a*: jym;rsm; xm;&Sday;&ef vdktyfonf? ajrmif;tdrfomudk w}udrfoHk;+yD;wdkif;ajr}uD;rsm;udk a*: jzifh aumfI rpifrsm;udk vHkavmufpGmzHk;tkyfay;&rnf? ajrmif;rsm; tpGef;rsm;ay:wGif xlxJaomtcif;rsm; ae&mcsxm;Edkifonf? tqdkyguJhodk@ xm;jcif;jzifh+rJ+rJajccsEdkdifjcif;ESifh ajr+ydKjcif;rsm;udk umuG,fEdkifonf?ajrmif;tdrfomonf ajr}uD;rS pifwDrDwm 30 tuGmta0;&Sdv#if tqdkyg ajrmif;udk ajr}uD;ESifhzHk;I aocsmpGmrSwfom;xm;+yD; aemufxyfajrmif;topfudk wl;azmfoifh onf?

euf&d_if;aom ajrmif;tdrfoma&&SnfoHk;pGJ&eftwGufudkrl euf&d_if;aom ajrmif;tdrfom

udk toHk;jyKjcif;onf oifhav#mfaomenf;jzpfonf? euf&d_if;aom ajrmif;tdrfomtm; 1 v rS 3 vtxd oHk;pGJEdkifonf?euf&d_if;aom ajrmif;tdrfomonf wdrfaomajrmif;tdrfomxuf usif;ydkrdkeufjcif;/ tvsm;ESifhteH ydkrdkI &Snfjcif;tjyifopfom;rsm;udk toHk;jyKEdkifjcif;/ yvyfpwpf odk@r[kwf owWKtumt&Hrsm;udk oHk;jyKEdkifonf? tnpfta=u;rsm;udkzHk;&eftwGuf ajr}uD;rsm;tm; ab;wGif yHkxm;oifhonf?rDodrf;"gwfESifh teH@toufxGufr_ enf;yg;ap&ef xHk;udktoHk;jyKEdkifonf?

omrefwGif;tdrfomvuf odk@r[kwf pufjzifh wl;aomwGif;udk toHk;jyKonfh

tdrfomonf a&&SnfoHk;&eftwGuf oifhav#mfaom a&G;

tnpfta=u;tnpfta=u;tnpfta=u;tnpfta=u;tnpfta=u;xde fxde fxde fxde fxde f ;odrf;jcif;ESi f h uav;i,frsm;;odrf;jcif;ESi f h uav;i,frsm;;odrf;jcif;ESi f h uav;i,frsm;;odrf;jcif;ESi f h uav;i,frsm;;odrf;jcif;ESi f h uav;i,frsm;

rsm;aomtm;jzifh uav;i,frsm;. rpifonf a&m*g ul;pufjcif;ydkrdkjzpfwwfonf? uav;i,ftrsm;pkonfrpifpGef@jcif;udk xdrf;odrf;EdkifpGrf;r&Sday? xdk@a=umifh uav;i,frsm; pnf;rJhurf;rJhrpifpGef@jcif;udk OD;pm;ay; wm;qD;&rnf?uav;i,frsm;. rpifudk vsifjrefpGmESifh usef;rma&;nDnGwfpGm pGef@ypfEdkifap&ef rdbrsm;udk tm;ay;oifhonf?uav;rsm;. tnpfta=u;rsm;udk jrKyfEHSr_ jyKEdkif&ef aygufwl;rsm;/ a*: jym;rsm;/ tdrfwGif;vkyfajrwl;ud&d,mrsm;tqifoifh xm;&Sdoifhonf?

rl&if; - Source: UNICEF

ISSUE 24, JUNE, 2004 39

factors, including local geology (condition ofsoil) and hydrogeology (condition of water andsoil), the communities’ culture and preferences,the materials available locally, and the cost.

Building Latrines

If there are no sanitation services, latrinesshould be built. Three options, appropriate fordifferent situations, are described below:

Shallow Trench LatrineA temporary solution for disposal of

excrement is a shallow trench latrine. Thesetrenches should never be used for more than aweek before they are covered and replaced.A community may decide to use a communaltrench latrine. A shallow latrine of 3-5 metersis needed for every 100 people. If this is done,a stock of shovels needs to be available. Aftereach visit, the user should shovel into the trenchsufficient soil to cover the excreta. Boards canbe placed on the edge of the trench to providestable footing and prevent the sides from cavingin. When the trench is filled to within 30centimeters of the top, it should be completelyfilled with soil, compacted, marked for futureidentification, and a new trench should be dug.(See illustration of shallow trench latrine.)

Deep Trench LatrineFor longer-term needs, a deep trench latrine

may be the appropriate choice. A deep trench

latrine can last for one to three months. It isdeeper, longer and wider than a shallow latrineand can be constructed using wood planks,plastic squatting plates, plastic sheeting or metalsheets. Soil is piled up and used to coverexcrement, the same as with the shallow trenchlatrine. Lime can be used to reduce thedevelopment of methane gas and odors. (Seeillustration of deep trench latrine - page 34)

Simple Pit LatrineIndividual simple pit latrines, hand-dug or

drilled, are the appropriate longer term choice.Family latrines are normally preferred, as theyare usually more than public facilities and thereare long-term benefits as far as maintenance.If given the proper advice and tools, a familycan dig its own latrine. Simple screening canbe used to provide privacy and give protectionfrom the weather. Tight-fitting lids on thesquatting holes are important for the control of

Excreta control and small children

Children’s faeces are generally more infectious than those of adults, and many childrenare unable to control their defecation, so preventing indiscriminate defecation by smallchildren should be a priority. Parents should be encouraged to clean up and dispose ofchildren’s faeces rapidly and hygienically. Shovels, small spades or home-made diggingtools made from wood should be available for parents to enable them to bury their children’sexcrement.

rl&if; - Source: WEAVE


cs,fr_jzpfonf? rdom;pkoHk;&eftwGuf omreftm;jzifhESpfouf=uonf? trsm;oHk;tdrfomxufvnf; ydkrdkoef@&Sif;onf? a&&SnfoHk;Edkif+yD; xdef;odrf;&efvnf; tqifajyonf?t}uH m%fESifh ypPnf;ud&d,mrsm;ay;v#if rdom;pkwpk onf‡if;wdk@udk,fwdkif tdrfomudk wnfaqmufEdkifonf? omreftumt&Hudk toHk;jyKI vHk+cHr_ESifh &moDOwk'%f umuG,fr_jyKvkyf Edkifonf? teH@touf/ jcifESifh,ifwdk@udk umuG,f&ef tdrfomtayguftm; aocsmpGm zkH;tkyfxm;&ef ta&;}uD; onf? tdrfomoHk; ajceif;jym;udk opfom;/ yvyfpwpf/uGefu&pfodk@r[kwf tqdkygypPnf;rsm;udk a&m aESmI jyKvkyfEdkifonf?

usif;tdrfomonf omreftm;jzifh 1 ESpfcef@ oHk;pGJEdkifonf? cdkifcef@r_r&Sdaomajrjzpfv#if tdrfomusif;r+ydK&eftumt&Hxm;&Sdr_vdktyfEdkifonf? tqdkyg tumt&Hudk 0g;/uGefu&pf odk@r[kwf pnfydkif;ta[mif;rsm;tm; toHk;jyKEdkifonf? wGif;.tumt&Hudk ajrjyifrS 50 pifwDrDwm teufatmufydkif; a&vHkr_jyK&ef rvdktyfay?

owdjyK&e ftcsufrsm;owdjyK&e ftcsufrsm;owdjyK&e ftcsufrsm;owdjyK&e ftcsufrsm;owdjyK&e ftcsufrsm;

u? ajr}uD;tajctae/ ae&ma'o tajctae/ oHk;pGJrnfholrsm; vufvSrf;rSDrrSDESifh ajray:/ ajratmufa&t&if; tjrpfrsm; teD;tem;wGif &Sdr&Sd ponfwdk@udk usif;tdrfom wck rwnfaqmufrSD avhvm&rnf?

c? ajr}uD;onf tdrfomwnfaqmuf&ef roifhav#mfv#if (ausmufcJrsm;pGm&Sdjcif; odk@r[kwf jrifhrm;aom a&tv$m &Sdjcif;)a&$‡ajymif;Edkifaom wdkifuDjzifh ajray:tdrfomudk wnfaqmufEdkifonf?tnpfta=u;rsm;udk oifhawmfaom ajrY&Sdonfhusif;twGif;odk@ tjrefqHk; jrKyfEHS&ef o,f,l pGef@ypf&rnf?

*? vlxktm; ynmay;&mwGif atmufygnGef=um;r_rsm;ESifh today;r_rsm; yg&Sd&rnf?

• tdrfomtm; rpifpGef@jcif;ESifh qD;oGm;jcif;udkomtoHk;jyKyg? (tjcm;ypPnf;ud&d,mrsm; tdrfomtwGif; odkkavSmifodrf;qnf;jcif;rjyK&)

• qD;oGm;jcif; odk@r[kwf rpifpGef@jcif;jyK+yD;aemufvufudk qyfjymESifh aq;a=umoef@&Sif;yg?

• =urf;cif;/ eH&HESifh tdrfomywf0ef;usifudk oef@&Sif;pGmxm;yg?

• tdrfomywf0ef;usifteD;tem;ESifh a&t&if;tjrpf&Sdaom ae&mrsm;wGif qD;oGm;jcif;/ rpifpGef@jcif;rjyK&? txufyguJhodk@jyKvkyfcJhv#if ,ifaumifrsm;/ avmufaumifrsm; jzpfyGm;&eftm;ay;+yD; a&pD;rSwqifh a&udk npfnrf;aponf?

xrf;[if;'kQonfxrf;[if;'kQonfxrf;[if;'kQonfxrf;[if;'kQonfxrf;[if;'kQonfpcef;pcef;pcef;pcef;pcef;ESif h oef@&Sif;a&; (tdrfom)ESif h oef@&Sif;a&; (tdrfom)ESif h oef@&Sif;a&; (tdrfom)ESif h oef@&Sif;a&; (tdrfom)ESif h oef@&Sif;a&; (tdrfom)

rsm;aomtm;jzifh '[email protected] udk,fydkifa&avmif;tdrfom rdom;pkwdkif;wGif &Sd=uonf?trftufpfzufzfrS axmufyHhaom yvyfpwpfp/ 0g;jzifhjyKvkyfxm;aomtrdk;tum/ a=uGtdk;ESifh bdvyfajrtdwfwpf0ufwdk@udk toHk;jyK+yD; 'kuQonfrsm;udk,fwdkif tdrfomudk aqmufvkyf=uonf? tdrfomusif;jynfhv#if usif;topfwl;+yD; a=uGtdk;ESifh bdvyfajrxyfay;onf?

rl&if;/ trf/ tufpf/ zufzf

a&G‡vsm;EdkifaomtzHk;

ajceif;jym;


ISSUE 24, JUNE, 2004 41

Sanitation in Tham Hin Camp ( Latrines)

Every family has its own flush latrine, usually at home. They made it by themselves withthe materials provided by MSF: plastic sheeting and bamboo for roof and walls, ceramicbowl, and half a bag of cement for the slab. When the latrine is full, they dig a new pit andare provided with a new bowl and cement.

Source: MSF

flies, mosquitoes and odors. The latrine slabcan be made of logs, plastic, concrete or acombination of these.

The pit latrine should normally last about oneyear. In areas of unstable soil, it might benecessary to line the pit to prevent collapse.Linings can be made from bamboo, concreteor old oil drums. Pit linings should not bewatertight below 50 centimeters deep. (Seeillustration of simple pit latrine.)

Points to Remember

a. Before installing a latrine, the soil at thesite must be evaluated along withtopographical (regional) conditions,user access, and the presence ofsurface and ground water in thesurrounding area.

b. If the land is not appropriate for latrineconstruction (rocky soil or high watertable), above ground latrines withremovable tanks can be built. Theexcreta must be transported to a pitlocated on appropriate ground, forimmediate burial.

c. Community education should includeinformation and instructions on:• Using the sanitation services only

for defecating or urinating (do notstore tools or other items in thelatrine).

• Washing their hands with soap andwater after urinating or defecating.

• Keeping the floor, walls, and areasurrounding the latrine clean.

• Not defecating or urinatingoutdoors in the area around thesanitation services or near bodiesof water, since this encourages theproliferation of flies and larvae andwater contamination through waterrunoff.

Resource material from: Environmental Health inEmergencies and Disasters, WHONatural Disasters: Protecting the Public's HealthGuide to Sanitation in Shelters and Camps, WHO

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trd_ufyHk - Refuse Disposal

ISSUE 24, JUNE, 2004 43

Solid waste may be refuse, manure, oranimal cadavers. There is a correlation betweenimproper solid waste disposal and the incidenceof vector-borne diseases. As a result,arrangements must be made to collect, store,and dispose of refuse and manure. Buryingor burning organic solid waste is recommended,and open dumping should be avoided. Greatcare must be taken in selection of a disposalsite. Once an area begins to be used as adisposal site, it can become a permanentdumping site.

Disposal of Solid Waste,including Medical Waste

Elisabeth Emerson,WHO

Medical Waste and hazardous waste needto be handled separately from common wastes.Recommendations for appropriatemanagement of these wastes are:

• Separate hazardous (toxic anddangerous), and sharp/medical wastefrom common waste. If possible, storethe hazardous and medical/sharp wastein strong containers with plastic covers.Dispose the common waste in a pit asdescribed above.

Health personnel and social workers need to have a basic knowledge of solid wastedisposal because improper disposal of wastes can lead to serious health problems.

This article illustrates two simple disposals of waste; burying and burning.

If there isno regularw a s t ecol lec t ionand finald i s p o s a ls e r v i c e ,waste shouldbe buried orb u r n e d .W a s t edisposal pitsmeasuring1.5 meterswide, 1.5 meters long, and 2 meters deep willserve a population of 200 for ten days. At theend of each day, cover the refuse with 15 cmof dirt and pack it down. The maximum size ofa pit should be 3 meters by 3 meters. Beforethe pit is full, cover it with a layer of packeddirt 40 cm thick so that it is level with theground. Then dig a new pit.

• Hazardouswaste can bedestroyed ina home-m a d eincineratorthat can bebuilt using afuel drumwith aventilationhole on theb o t t o m .Inside theremust be a

grill to hold the waste. The ashes can bedisposed of in the pit for common waste.(See illustration of incinerator.)

• Sharp waste (needles and glass) can bedisposed of in a hole or pit with 1 m3

capacity, covered with a heavy concreteslab. A tube 2 inches in diameter, runningthrough the slab and extending roughly

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ISSUE 24, JUNE, 2004 45

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1.5 meters above it, can be used fordepositing needles and surgical bladeswithout syringes or venoclysis(intravenous injection application) tubes.

• Dead animals and excrement fromdomestic animals must be buriedimmediately, since they can be a sourceof contamination.

Sanitation in Tham Hin Camp (Refuse)

MSF (Medecins Sans Frontieres) as a team manages 6 garbage areas in Tham HinTemporary shelter. These areas are located on the edge of the camp. The communitydispose of their own garbage. At home they first sort out the dry one (plastic, bamboo,paper...) from the wet one (kitchen leftovers, cooking water, rice...) in two different containers(plastic bag or oil tin or bucket). They bring them to the garbage area and empty them atthe appropriate place: the wet garbage in the wet pit (a 9m3 hole covered with a bambooand plastic sheeting cover), and the dry garbage at an open burning site. Every garbagearea is managed by one sanitation worker. He helps people to carry and throw their garbagein the right place; he cleans and keeps the pit cover closed; he takes care of the fire. Healso maintains his work area and the surroundings. MSF hires community members toclean regularly in the camp.

Source: MSF

Resource material from- Environmental Health in Emergencies

and Disasters, WHO.- Natural Disasters: Protecting the Public’s

Health.- Guide to Sanitation in Shelters andCamps, WHO.

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ISSUE 24, JUNE, 2004 47

Rodents make up more than 42 % of theknown mammalian species and they play animportant role as reservoirs of disease-causingagents (pathogens) in the transmission ofdiseases to other mammals around them.

Methods of disease transmission byrodents

Disease causing agents are transmitted by:• ectoparasite (flea) of the rodent which can

transmit plague and typhus• rodent excreta which can transmit

salmonella and leptospirosis.• rat bite fever

Biology of the rat and the mouse

Domestic rodents can be identified most

This article is an introduction to the biology of different rodents and the controlmethods, which will help the medics

and social workers to combat rodent problems in their environment.

commonly as three species: the black rat, thebrown rat and the mouse.

The black ratThe adult measures about 40 centimeters

(about 16 inches) and weighs about 250g. Themouth (muzzle) is pointed, the ears round andprotruding from the fur, and eyes protuberant.The appearance may be dark gray or brown.

The nest is generally built on the ground, invegetation or in trees (and exceptionally in aburrow or sewer).

In houses the nests are generally built underthe roof and the high-flying areas.

The diet is very varied (vegetable andanimals). Sexual maturity is reached at twomonths.

The brown rat (or sewer rat)

Rodent ControlHealth Messenger Team

The colour is generally brown. Itis bigger than the black rat and mayexceed 400g. Its mouth is roundedand the eyes are smaller than thoseof the black rat.

Nests are built in burrows withan entrance diameter of about 8centimeters.

The diet is less varied than thatof the black rat. The brown ratprefers refuse and human waste.

The domestic mouseThis is a well know universal

species. Its biology is similar to that


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py&defoHk; =uGufaxmifacsmufud&d,monf txda&mufqHk; axmifacsmufjzpfonf? t"duusaomtcsufrsm;rSmaxmifacsmufrsm;pGm oHk;jcif;/ =uGufvrf;wav#mufwGifaxmifacsmuftm; uef@vef@jzwfxm;I &ufaygif;rsm;pGm=umatmif armif;udkrwifbJ xm;&Sd&rnf? xdk@uJhodk@ jyKvkyfrSom =uGufaxmifacsmufESifh =uGufrsm; xdawG@r_&Sd+yD;aemiftcsdefumvwGif axmifacsmufudk toHk;jyKEdkifrnf?(tdrf=uGufi,frsm;axmif&mwGif az: jyygenf;udk toHk;rjyKEdkif) aocsmpGmae&mcsxm;aom axmif acsmufrsm;wGif=uGufpm;&eftpmxnfh&efrvdkay?

4/ =uGufowfaq;oHk;pGJjcif;w}udrfoHk;=uGufowfaq;ESifh t}udrfrsm;pGmoHk; =uGuf

owf aq;[lItrsKd; tpm;ESpfrsKd;&Sdonf?

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onfESifh aoqHk;EdkifrSom tmedoif&SdEdkifonf? odk@r[kwfv#if=uGufonftqdkygaq;udk aemufxyfw}udrf pm;oHk;rnfr[kwfyg?

T=uGufowfaq;rsm;onf tvGeftqdyfjyif;I=uGufrsm;udk ESdrfeif;&mwGif txl;u|rf;usifr_ESifh tawG@t}uHKrsm;vdk tyfonf? odk@rSom atmifjrifpGm oHk;pGJEdkifvdrfhrnf?

t}udrfrsm;pGmoHk;=uGufowfaq;rsm;Taq;rsm;onf yr%tenf;i,fomoHk;I t}udrf

rsm;pGm pm;oHk;+yD; pkaygif;tmedoifa=umifh =uGufaoqHk;ap&efjzpf onf? tqdkygaq;wGif tm;omcsuf ESpfcsuf&Sdonf?

• tqdkygaq;. aES;auG;pGm tmedoif&Sdr_onf =uGufrsm;t}udrf}udrfpm;oHk;ap&ef zefwD;I aoqHk;aponf?

• tqdkygaq;.tmedoifonf vlrsm;ESifhtjcm;tdrfarG;owW0grsm;twGuf tEW&m,fydkenf;onf? xda&mufaom ajzaq;vnf;&Sdonf?

tqdyf - pmwrf;udk xif&Sm;pGma&;+yDaz: jyxm;&efta&;}uD;onf?

rl&if; ? trftufpftyfzf jynfolusef;rma&; u|rf;usifolrsm;vufpGJ/ 1994 yxrt}udrf &dkufESdyfjcif;?

ISSUE 24, JUNE, 2004 49

of the rats. The mouse can survive with thewater enclosed in food, whereas the rat needsfree water.

Its maximum weight is 20g and its length 20centimeters. For two animals of the same size,the head and the feet are larger than those ofthe young rat.

Nests are built any place where there is anaccumulation of material for making the smallshelters, which the mouse needs. Therefore,making control difficult.

Control Methods

1. Environmental HygieneLike many other vectors, the environment

should be created so that it is unsuitable forrodents to live. The stored food should be keptbeyond the reach of rats. It is essential to disposeof refuse in a systematic way in order to denyaccess to the rat. Elimination of likely sites toreduce reproduction should be carried out.

2. Protection from RodentsThe aim of protection from rodents is to

prevent access by rodents to important orvulnerable areas (food stores, water, liquids,etc). Block or protect all openings greater than6mm with cement or metal netting (1mm wiremesh less than 6mm diameter). Place discs oncables (rat proof). Paint a smooth band on wallsat 1 meter from the ground to prevent passageon rough vertical surfaces. Fix aluminum orgalvanized sheet (1mm) at the bottom of doorsand on the skirtings.

Repair all broken packages. Leave apassage (1mm) between walls or pillars andstacks, to allow inspection. Stack bags withcare, leaving sufficient space between the topof the stack and the roof. Clean the storagearea daily and never let a stack remain intactfor more than a month. Inspect the storage areaat least once a week for insects, signs of

damage, presence of rodents and throw refuseaway regularly.

3. TrappingThis method never achieves complete

eradication by itself. Trapping can be used toget rid of the last few survivors left from achemical control campaign or individuals of anisolated and small infestation.

Spring traps are the only efficient models. Thekey points to follow are to use many traps. Theyshould be placed across the rodent’s path andtraps should be left unset for several days so thatthe rats become used to them (except for mousetraps). A well-placed trap does not need bait.

4. PoisoningSingle-dose poisons and multi-dose poisons

can be used for rat poisoning.

Single-dose poisonsThese are only effective if the rat ingests a

lethal dose at the first feed, otherwise the ratwill not go back to the bait again.

These poisons are extremely toxic and, inaddition, they require special skills and experiencein rodent control if they are to be effective.

Multi-dose poisonsThese are poisons with a cumulative effect

used at low doses, which have two advantages:• The slowness of their effect allows the

animal to absorb a lethal dose before thefirst effects are felt.

• Their mode of action makes them lessdangerous to man and other domesticanimals, and there is an effective antidote.

Important to label the box with thesafety message: POISON

Source: MSF Public Health Technicianmanual 1994 - 1st edition


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'v+rdK@wGif at/ trf/ tdkif .a&ESifhoef@&Sif;r_vkyfaqmifcsufrsm;

usef;rma&;apwrmeftzGJ@ESihf at/ trf/ tdkif - jrefrm wdk@yl;wGJa&;om;onf

pDrHudef;

csdK@wJhaomvlrsm;pktm;OD;wnf+yD; attrftdkif onftqifhrSDaom a&ay;jcif;ESifhusef;rma&;ynmay;jcif;ukdausmif;aygif; 30 ESifh'v.tajctaetqdk;qHk;a'orsm;wGif aqmif&Gufv#uf&Sdonf? enf;ynmydkif;ESifh ynmay;tydkif;udk vlxktm; tultnDay;I tqdkygvlxktaejzifhatmufygwdk@udk wnfaqmuf xdrf;odrf;r_rsm; jyKjyifEdkifap&efvkyfaqmifay;onf?

- rdk;a&cH odkavSmifuefrsm;- oef@&Sif;aom tdrfomrsm ;- ydkufwGif; ESifh a&pkyfpuf- umuG,fr_ jyKvkyfxm;aom a&uefrsm;?

vlxkyg0ifvkyfaqmifjcif;

'v+rdK@e,ftwGif;wGif a&ESifh qufEG,fv#uf&Sdaoma&m*grsm; a&&Snfusqif; E d ki f&e ftwGuf vlxk

Community Participation

Taqmif;yg; onf vlxkyg0ifvkyfaqmifr_ESifh atmifjrifaom vlxkv_yf&Sm;r_jzpf&ef enf;ynmay;jcif;wdk@ta&;ygyHkudk rD;armif;xdk;jyonf?

ISSUE 24, JUNE, 2004 51

Since 2002, Aide Medicale International hasbeen running a water and sanitationProgrammein Dala, one of Yangon’s pooresttownships. Based on community participation,the programme provides quality water to 30schools and more than 20,000 people.

Across the river from Yangon, DalaTownship is home to 100,000 people, mostlyBurmese workers who commute every day towork in the city. Often living under extremepoverty, they suffered from poor sanitation andmany water-related diseases. Before AMIstarted its programs, getting water wasachieved either by buying government waterfrom mobile venders or by helping oneself inthe murky waters of the many ponds in thetownship. Unprotected ponds oftencontaminated by animals and lack of hygieneawareness resulted in high rates of dysentery,diarrhoea and skin diseases.

The Programme

Focussing on the most vulnerablepopulation, Aide Medicale Internationaleprovides quality water and health education to30 schools as well to the most affected areasof Dala. The programme provides technicalassistance and education to help the populationbuilt and maintain:• Rain collectors• Sanitary latrines:• Tube wells with pumps:• Protected ponds:

AMI Water and Sanitation Activities inDala

Health Messenger Team in Collaboration with AMI-Myanmar

This article highlights the importance of community participation and providestechnical tips to create successful community dynamics.

Community Participation

Raising the awareness on safe water andengaging in a community participation approachare crucial to ensuring a long-term reduction ofwater-related diseases in Dala Township. Butmobilizing people, not used to working together,can be a challenging task.

The System

The water and sanitation programme in DalaTownship provides technical assistance andhealth education to groups of 10 to 12 familieswho are committed to taking part in theconstruction and management of latrines, raincollectors and pumps. They are called : WaterUser Group.There are hundreds of WUGsinvolved in the Dala sanitation programme.Each group is responsible for the construction,maintenance and management of an ‘’hygienekit’’: combining latrines, a pump and a raincollector. The WUG select a leader who willbe in charge of all aspects of the project:managing the community financial contribution(money paid by the family to use the water andwhich creates a reserve fund to maintain or fixthe water facilities) and ensuing that the facilitiesare clean and operational.

Raising Community Participation inWater Sanitation Programmes

Example of strategies to raise community


udk,fwdkifyg0ifvkyfaqmifjcif; pepfESifh pdwfcs&aoma&ta=umif; tao;pdwf od&Sda&;wdk@onf ta&;ygaomtcsufrsm; jzpfonf? twlpk aygif; vkyfavhr&Sdaomolrsm;udk yg0ifpkaygif;vkyf&ef v_yf&Sm;r_onf pdrfac:r_w&yfjzpfonf?

pHepf

'v+rdK@e,fwGif vkyfaqmifv#uf&Sdaom a&ESifh oef@&Sif;r_pDrHudef;onf tdrfaxmifpk 10 ckrS 12 cktxd usef;rma&;ynmESifh enf;pepfydkif;qdkif&mudk jyKpkysKd; axmifay;xm;onf?tqdkyg tdrfaxmifpkrsm;onf tdrfomrsm;/ a&odkavSmifuefrsm;ESifh a&pkyfpufrsm;udk aqmufvkyfjcif; pDrHjcif;rsm;jyKvkyf=uonf? olwdk@tm; a&oHk;pGJolrsm; tkyfpk[k ac:onf?tkyfpkwdkif;onf oef@&Sif;aomtoHk;taqmifwckudk wnfaqmufjcif;/ xdrf;odrf;jcif;ESifh pDrHjcif;wdk@udk jyKvkyf&onf?oef@&Sif;aom toHk;taqmifqdkonfrSm tdrfomrsm;/a&pkyfpufESifh rdk;a&odkavSmifpkaqmif;uefwpHkudk qdkvdkonf?a&oHk;pGJolrsm;tkyfpkwGif acgif;aqmifwOD;tm; a&G;cs,f+yD;pDrHcsuf. udpPrsm;udk wm0efcHaqmif&Gufaponf? vlxk.xnfh0ifaom aiGa=u;udpPrsm;udkvnf; wm0ef,laponf?Oyrm a&oHk;&ojzifh xnfh0ifaomaiGrsm;udk a&t+rJ&&Sda&;udpPrsm;twGuf oHk;pGJjcif;? oef@&Sif;r_&Sdap&efaqmif&Gufjcif;ESifh tpOft+rJa&&&ef aqmif&Gufjcif;wdk@ jzpfonf?

vlxkyg0ifvkyfaqmifr_jzpf ay:apjcif;?

pDrHudef;onf az: jyygtqifh 14 qifh ay: rlwnfaqmif&Gufonf? Oyrmrsm;

tqifh 1? tkyfpkzGJ@apjcif;?(vlxk.aemufcHjrifuGif;)? ? tkyfpkwGif toufi,f

aomolrsm; touf}uD;aomolrsm;/ a,muFsm;rsm;/rdef;rrsm;/ qif;&Jaomolrsm;/ csrf;omaomolrsm; pojzifhyg0if=uonf? tvkyftwlvkyf=u&ef tkyfpkonfoufawmifhouf om tajctaersm;udk vdktyfonf? TtpDtpOfrprSD ay#mf&$ifp&m vkyfaqmifr_wckckjzifh ed'gef;ysKd;oifhonf? xdk@aemuf attrftdkif 'v+rdK@e,f&Sd a&ESifhoef@&Sif;r_vkyfaqmifr_rsm;udk tusOf;+cHK;wifjyoifhonf?

tqif h 2 ?vlxk.a&ESif h oef@&Si f;r_vd ktyfcsufud kxkwfaz: jcif;

Tvkyfaqmifcsufonf vlwOD;csif;pD. vdktyfcsufudkodap+yD; toif;tzGJ@pdwf"gwf&ap&ef jzpfonf? Oyrm - vl

5 OD;ygaom tkyfpki,fav;rsm;zGJ@ay;yg? tkyfpkwdkif;udk a&ESifhoef@&Sif;r_ESifhqdkifaom yef;csDum;rsm;udk a0iSxm;yg?xdkaemuf xdkyef;cs Dum;rsm;udk toHk;jyK+yD; vlxk.a&ESifhoef@&Sif;r_ jy\emrsm;udk wifjyef&ef zdwfac:yg?tqdkygwifjycsufrsm;onf aqG;aEG;&ef udpPrsm;jzpfvmygrnf?

vlxk.usef;rma&;jy\emrsm;? ? txufygtwdkif;yef;cs Dum;rsm; ay;I usef;rma&;jy\emrsm;tm;a&ESifhoef@&Sif;r_wdk@jzifh qufpyf+yD; vufawG@=uaomtajzrsm;& Smc d ki f ;y g? Oyrm - 0r f;avsmjci f ;E Si f hAdkufemjcif;yHkrsm;udk toHk;jyKyg? rnfonfhtwGufa=umifhaeraumif;jcif;jzpf&onfudk ajymygap? rnfuJhodk @umuG,fEdkifa=umif; ajymygap?

tqifh 3 ? jy\em qef;ppfjcif;?tkyfpktm; vlxkyg0ifaom yHkqGJr_jyKvkyfygap? vrf;rsm;/

ausmif;rsm;ESifh tjcm;taqmuftOD;rsm; yg0ifygap? tkyfpkudk 2 ckcGJyg? wpkonf tdrf&Sifjzpf+yD; aemufxyf wpkonf{nfhonfjzpfonf? yxr tkyfpkrS 'kwd,tkyfpkudk a&ESifhoef@&Sif;r_ESifhqdkifaomt&mrsm;udk wifjyygap? vlxkvuf&SdoHk;pGJaeaom t&mrsm;udk odjrifap&efjzpfygw,f?

tqifh 4 ? pdwfcs&aom a&vdktyfr_udk az:xkwfyg?&moDtvdkuf a&vdktyfcsuftrsKd;rsK d;udk jyo&ef

&nf&G,fonf? jyuQ'deftm; toHk;jyK+yD; &moDtvdkufa&twGuftoHk;jyKrnfaiGtiftm;udk cef@rSef;cdkif;yg?

tqifh 5 ? twlwGJ+yD;tvkyfvkyfjcif;yifhulupm;enf;jzifh twlwGJ+yD; tvkyfvkyf&efvdktyf

a=umif; az:xkwfyg? tkyfp kvd kuf vufcsi f;wG J +y D;puf0dkif;yHkpHvkyfaqmifyg? wOD;csif; za,mif;wdkifwwdkiftm;tyfcsnfjzif h cs D +y D; xdef;xm;yg? acgif;aqmifonfza,mifwdkif udk ykvif;xJ xnfh&ef vrf;n$efyg? (yHkwGif=unfh)

tqifh 6 ? nDnGwfjcif;onftiftm;aqG;aEG;jcif;tm;jzifh toif;wcktaejzifht vkyfvkyf

&mwGif tm;omcsuf ESifh tm;enf;csufrsm;udk em;vnfygap?

tqifh 7 ? tkyfpkvdkuf v_yf&Sm;wuf=uGr_tkyfpkvd kuftvkyfvkyf jcif;. tcuftcJrsm;ud k

aqG;aEG;yg? wOD;csi f; }ud K;pm;jcif; jzi f h wlnDaomyef;wdkifa&muf&ef vkyfEdkifyHkudk aqG;aEG;yg? vltrsKd;rsKd;wdk@

ISSUE 24, JUNE, 2004 53

participation: the program follows 14 steps:

Step 1: Forming a group:The community’s background: The group

should involve young and old, men and women,poor and rich people. To work together, thegroup needs a relaxed atmosphere. Sessionswill, therefore, often begin with fun activities tobreak the ice. Then AMI activities in Dala arebriefly presented.

Step 2: Identification of the community needsin sanitation:

These exercises aim to build team spirit andmutual understanding of everyones needs. Forexample a group is divided in to several sub-groups of 5 people. Each group is given severalcards with drawings related to water andsanitation issues and then invited to tell a storyabout their community’s water & sanitationproblems, using these cards. The stories willstimulate discussions on the issues raisedthrough the game.

The community’s health problem: The aimof the following exercise is to help the

Step 3: Problem analysisThe group is asked to map the respective

community’s roads, schools and all facilities.Then the group is divided into two groups. Onerepresent the host; the other one the visitor. Thefirst group will have to describe and introduceits community and in particular its watersanitation facilities to the second group. Thepurpose of this "tour" is to take a perspectiveon the community facilities.

Step 4: Identification of the need for water:The aim is to show the different needs of

water according to the seasons. Using acalendar, people are encouraged to forecastthe amount of money they will spend on waterfor each season.

Step5: Working together…The spider games illustrate the need to work

together. The group hold hands in a circle. Eachof them hold a string to which is tied a candle.The leader is trying to get the group to put thecandle in the bottle by guiding the othermembers.

community identifyhealth problemslinked to water andsanitation and thinkabout practicalsolutions.

Using drawingsto illustrate differenthealth problems, forexample, diarrhoea,stomachache…thegroup is encouragedto describe why theperson is sick andwhat can be done toprevent the illness.

yifhulupm;enf; - The spider games


ta=umif; az:xkwfyg? jy\em&Smol/ udkzdk;od vkyf wwfol/EkwfeJol/ taumif;jrifwwfol/ rd&dk;zvm t,ltq&Sdol/aphpyfay;wwfolponfwdk@udk aqG;aEG;yg?

tqifh 8 ? acgif;aqmifrsm;. tcef;u‡acgif;aqmifaumif;wa,muf. t&nftcsif;rsm; udk

az: jyyg? tkyfpkwcktm; xdrf;+yD; taxmuftulay;Edkifonfhacgif;aqmifwOD;. tcef;u‡udk aqG;aEG;yg?

&xm;upm;enf; / acgif;aqmifaumif;onfrsufaphydwfxm;aomolrsm;tm; vrf;n$efEdkifr_udk jyoyg?nmykcHk;ykwfv#if nmauG@+yD; b,fykcHk;tm; ykwfv#ifb,fauG@pojzifh vrf;n$efay;yg?

tqifh 9 ? rnfonfhtcsufonf acgif;aqmifaumif;jzpfapovJ?

acgif;aqmifr_trsKd;rsKd; aqG;aEG;yg? trdef@ay;aqmif&Gufol/ nSdEd_if;aqmif&GufolESifh vkyfudkifEdkifpGrf;&Sdol pojzifhaqG;aEG;yg?

tqifh 10 ? acgif;aqmifa&G;cs,fyHk?tkyfpkvdkuf vdktyfaomacgif;aqmifudk &SmazGcdkif;yg?

wOD;csif; acgif;aqmiftrnfudk pm&GufwGifa&;cdkif;yg?

&xm;upm;enf; - The train game

pm&GufwGif a&;ol.trnfudk az: jy&ef rvdkyg?

tqifh 11 ? b‡ma&;r_;rsm;.tcef;u‡a&&&Sda&;twGuf ypPnf;rsm; xdef;odrf;apmifha&Smuf&ef

ukefaiGrsm; aumufcHr_wm 0ef,l&rnfol &Sd&rnf? b‡ma&;r_;.t&nftcsif;rsm;udk aqG;aEG;yg? a&G;cs,f cH&oltm;pm&if;tif; xdrf;odrf;r_ oifwef; ay;ygrnf?

tqifh 12 ? aiGaumufcHr_a&udpPtwGuf toHk;jyK&ef aiGaumufcH&ef aqG;aEG;yg?

aiGaumufcHrnf yH kp Hud k a&;qG Jyg? vd ktyfcsuft&aiGyrm%rnfr# aumufcHrnfudk qHk;jzwfyg? rnfonfhenf;jzifhaiGaumufcHv#if oifhrnfudk qHk;jzwfyg? Oyrm vpOfaumufcHjcif;/ ae@pOfaumufcHjcif;?

tqifh 13 ? rSwfwrf;xdrf;odrf;jcif;?vkyfief;wckpD. oyf&yf+yD; tcsdefrSefrSwfwrf;wifr_

ta=umif; aqG;aEG;yg?

tqifh 14 ? tpnf;ta0;rsm; wufa&mufjcif;?tpnf;ta0;rsm; wufa&muf&ef ta&;}uD;a=umif;udk

upm;enf;rsm;/ aqG;aEG;jcif;enf;rsm;jzifh tkyfpktm; odygap?

ISSUE 24, JUNE, 2004 55

Step 6: Unity is strengthA series of discussions help the group to

understand the advantages and disadvantagesof working in a group.

Step 7: The group dynamicDiscussion on the difficulties of working as

a group and the effort that everyone cancontribute in order to reach a commonobjective. The different types of group membersare identified: complainers, know-it-alls, quietmembers, positive members, traditionalists,bridgebuiders, etc..

Step 8 : The role of leadersWhat are the main qualities of a good

leader?Discussion on the role of a leader in

maintaining and supporting a group.The train game: A good leader will be able

to guide his blindfolded team by tapping on theirshoulders: right shoulder means going to theright and left to turn to the left.

Step 9: What makes a good leaderDiscussion on what the groups think of

different leaderships: a leader who commands,

a leader who consults, a leader who enables…

Step 10: Choosing the right leaderThe group is pushed to identify the kind of

leadership they need, and according to all theelements discussed earlier, each person writesthe name of the leader they have chosen. Thevote is anonymous.

Step 11: The role of treasurers:One person will be responsible for collecting

money from the participants for the use andmaintenance of the water facilities.The qualitiesof a good treasurer are discussed with thegroup. The person chosen will be trained onkeeping basic accountancy.

Step 12: The money collection:The group will explore what they are ready

to pay for the new water facilities and organisethe collection of money. The group will decidehow much they want to give according to theirneed and what is the most appropriate way ofcollection for them: monthly, daily, etc

Step 13: Keeping Records:Discussions on the importance of clear and

regular recordkeeping foreach activity.

Step 14:A t t e n d i n gmeetings

Throughgames anddiscussions,t h eimportance ofa t t e n d i n gmeetings isstressed to thegroup.Attending meetings


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attrftdkifESifh tvkyfvkyfaeonfrSm rnfr#=um+yDvJ?udkvkvk.t"du wm0efrSm rnfonfht&mrsm; jzpfygovJ?

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wcgw&H 0rf;avsma&m*grsm; jzpf=uygw,f? usaemfr dom;pkawmifr S E Sp fcgavmuf c Hpm;&ao;w,f?aq;cef;oGm;awmhvnf; tifrwef aiGukefygw,f?'DESpfrSmawmh usaemfwdk@.&yfuGufrSm 0rf;avsm*grsm;jzpfa=umif;r=um;&awmhyg? pDrHcsufu usef;rma&;twGufukefusrnfaiGudk enf;yg;apygw,f?Sanitary latrine

ISSUE 24, JUNE, 2004 57

Ko Lu Lu (Watsan Educator)

How long have you been working withAMI? What are your main responsibilities?

I have been working with AMI for twoyears. My main responsibilities are forming usergroups for every 10 households andmaintenance training of the caretakers of thewater facilities.

What has been the main constraint in youractivities?

Time limitation has been a critical constraint.It is a very difficult task to adapt our timing tothe communities' timing.

What changes due to the project have youobserved?

The changes in project areas have been quiteevident. There were barely any householdlatrines in the project area. Most of the latrinesbefore the project were unsanitary. I found thesmell of the wards to be very bad. Now theyhave family latrines. The community used to get

Interview with Water UsersHealth Messenger Team in Collaboration with AMI-Myanmar

domestic water from the makeshift small pondsin front of their houses, of which the waterquality was very bad. Now I can see that theyare using water from the shallow tube wellthrough assistance from AMI. A few peopleare still using the turbid water for domesticusage. But, comparatively very few. Before theproject, the average family had to buy drinkingwater, which cost 150 – 300 kyats. Now thefamily expenditures have been significantlyreduced.

U Nyein Maung (User)

What is your job?I work in pearls and fisheries.

How long have you been staying in Dala?About seven years.

What was the water situation like beforethe project?

It was very difficult. A bucket of water is20 kyats. Even if we are willing to spend forthat, there are no sellers sometimes. And wehad to buy and drink the water from shallowtube wells, whose taste is totally unsatisfactory.The water sellers brought the drinking waterfrom Yangon.

Were there any health problems due towater? And has there been any change?

Diarrhoea occurred sometimes. Even ourfamily suffered two times. It was quite costlyto go to the clinic. This year I haven’t heard ofany diarrhoea cases happening in our ward. Theproject well has reduced the health cost.

Sources of water


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ISSUE 24, JUNE, 2004 59

How is the RWC(rainwater collector) andshallow tube well working?

We hope we can depend on the RWC untilthe end of March for our drinking water. Thewater from the shallow tube well is not cleanenough to drink. But if we keep it overnight,we can use it for domestic purposes.

Daw Thaung Thaung Aye (User)

What is your job?I look after my family. My husband is a

labourer at the jetty.

How long have you been staying in Dala?About six years.

How did you get your water before theproject?

We had to buy drinking water from the watersellers and use water from the shallow tube wellsfor the home.

What changes due to AMI project haveyou observed?

The cost due to water is greatly reduced.We are very happy that the water we aredrinking and using now is good. Now, we aredrinking the water from RWC and using the

water from shallow tube well with an ironremoval system, which was constructed byAMI.

U Kan Min (WatSan Officer, AMI)

What are your responsibilities in AMI DalaProject?

Supervision of all the engineers, preparationof technical designs and overall supervision

What was the situation in Dala like beforethe project?

Before the project, I had been to Dala acouple of times on my trips to Twantay. In2002, I arrived there on duty. I observed thatthere were many households without a watersource. People had to depend solely on Yangonwater. The water from Kyan Sit Tha Ward wasvery turbid. There were no latrines. Domesticwater was also scarce. People looked quitedownhearted. The majority of the people livingin Dala are hand-to-mouth workers. They hadto spend about 20% of their income for water.For those who couldn’t afford to buy it, theyor their children had to fetch water. The watersources were quite far, so they had to spend alot of time on fetching water. What I mean isthat people had to spend a lot of time and money

to get water and the water theygot was not clean.

What activities is AMI doingin Dala?

It started with water,sanitation and health educationactivities. AMI has provided theWatsan facilities. This year,assistance is being provided to14 primary schools, 6 middle/high schools, and householdsfrom four wards. The mainprojects AMI is doing in Dala isClean water means healthy


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ISSUE 24, JUNE, 2004 61

water and sanitation, mother and childhealthcare, HIV/STD prevention and healtheducation at schools.

What changes due to the project have youobserved?

Tangible changes are the physical facilities.But there are some intangible changes. People'shappiness. People can spend more time andmoney on other things rather than fetch water.AMI activities have reduced the livelihoodburden of the inhabitants. For example, theyget some earnings for baking the bricks, hiringthe trailer jeep, etc. Such things indirectly affect4-500 families. People have become calmerthan before.

Daw Hnin Hnin Kyaw (Education Officer,AMI)

What are your responsibilities in thisproject?

Supervision of five community educatorsand four school educators, Interaction withcommunities, departments, township educationofficessr and headteachers.

What was the situation of Dala like before

They had to spend a lot of money. Some hadto fetch water from quite a distant location. Theponds they used were not protected. Peoplesuffered from diarrhoea and skin diseases.Children suffered from worm infection.

What activities did AMI do?AMI constructed rainwater collectors and

hand pumps with a scale of 1 unit per 10households. Ponds were renovated includinginstallation of fencing and hand pumps.

What constraints have you faced?In terms of community level, it is a peri-urban

setting. The majority are hand-to-mouth dailywage workers. They have survival problems.It is very difficult to compromise the timing oftheir involvement.

What kind of impact due to the project haveyou observed?

The distance to fetch water is reduced.There is no need to worry about the drinkingwater. People can save some money for otheruses. There is better personal hygiene due tosufficient domestic water. The township medicalofficer has mentioned that nobody has beenhospitalized for diarrhoea this year.

Polluted water can cause diseases

the project?Dala is a

flood-pronearea. Mostareas of Dalaare flooded inthe rainyseason. But indry season,they face aw a t e rs c a r c i t y .People didn'thave water asthey liked.


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jrefrm'kQonf axmifaygif;rsm;pGmwdk@onf ae.pGrf;tifrS tusKd;aus;Zl;rsm;pGm&&Sdonf?jrefrm'kQonf axmifaygif;rsm;pGmwdk@onf ae.pGrf;tifrS tusKd;aus;Zl;rsm;pGm&&Sdonf?jrefrm'kQonf axmifaygif;rsm;pGmwdk@onf ae.pGrf;tifrS tusKd;aus;Zl;rsm;pGm&&Sdonf?jrefrm'kQonf axmifaygif;rsm;pGmwdk@onf ae.pGrf;tifrS tusKd;aus;Zl;rsm;pGm&&Sdonf?jrefrm'kQonf axmifaygif;rsm;pGmwdk@onf ae.pGrf;tifrS tusKd;aus;Zl;rsm;pGm&&Sdonf?

*&if; trfyg0grufonf xdkif;/ jrefrme,fpyfwav#muftvkyfvkyfaeaom usef;rma&;0efxrf;rsm;tm;aea&mifjcnfrS v#yfppfpGrf;tif xkwfvkyfenf;/ xdef;odrf;enf;ESifh tjypf&Smenf;rsm;udk oif=um;ay;onf?Tenf;tm;jzifhtvif;a&mifESifh v#yfppfoHk;aq;ypPnf;ud&d,mrsm;udk toHk;jyKaponf?

rl&if;? *&if; trfyg0gruf Ak'<[l;ae@/ 21 {+yD/ 2004

ISSUE 24, JUNE, 2004 63

Water disinfection by sunlight is a simpletechnology used to improve the quality ofdrinking water. It uses sunlight to destroy germs,which cause waterborne diseases.

This method is ideal for treating smallquantities of water. Transparent plastic bottlesare filled with contaminated water and exposedto full sunlight for six hours.

Sunlight treats the contaminated waterthrough two mechanisms which cooperate inperforming a disinfection process. The firstmechanism uses radiation in the form of UV(ultraviolet) rays and the second is increasedwater temperature. If the water temperature israised above 50 degrees centigrade, thedisinfection process is three times faster.

Key factors of sun disinfection:

• It requires sun radiation and temperature.

• It needs to be exposed to the sun for 6 hoursif the sky is bright or up to 50% cloudy.

• It needs to be exposed to the sun for 2consecutive days if the sky is 100% cloudy.

• If a water temperature of at least 50 degreecentigrade is reached, an exposure time of1 hour is sufficient.

• It requires relatively clear water.• Various types of transparent plastic

materials are good for sun disinfection.• Ordinary window glass of 2 millimeter

thickness is practically opaque to ultravioletradiation.

• Heavily scratched or old, blind bottles(aging plastic bottles) should not be used.

• Increased water depth reduces sundisinfection (at a water level of 10centimeters or about 4 inches and moderateturbidity, ultraviolet radiation is reduced to50%).

Health Messenger Team

Solar Energy Benefits Thousands of Burmese Refugees

Green Empowerment has taught the medics working along Thai-Burmese border howto build, maintain and troubleshoot photovoltaic (electricity generated from sunlight) systemsthat provide electricity for lighting and medical equipment.

Source: Green Empowerment, Wednesday, April 21, 2004

Drinking water should not contain any disease germs known to be harmfulto humans. It should also be free from bacteria, which is an indication ofpollution with human faeces. This article describes a simple method to

make drinking water safe for people living with limited resources.

Water Disinfection By Sun


(tqif h 4)(tqif h 4)(tqif h 4)(tqif h 4)(tqif h 4),cky kvif;tm; jynf hatmif a&jznf hI tzH k;tm;,ckykvif;tm; jynf hatmif a&jznf hI tzH k;tm;,ckykvif;tm; jynf hatmif a&jznf hI tzH k;tm;,ckykvif;tm; jynf hatmif a&jznf hI tzH k;tm;,ckykvif;tm; jynf hatmif a&jznf hI tzH k;tm;z k H ;xm;yg?z k H ;xm;yg?z k H ;xm;yg?z k H ;xm;yg?z k H ;xm;yg?

(Step 4)Now fill the bottle fully and close the lid.

(tqif h 3)(tqif h 3)(tqif h 3)(tqif h 3)(tqif h 3)ykvif;tm; pUef@ 20 cef@ v_yfyg?ykvif;tm; pUef@ 20 cef@ v_yfyg?ykvif;tm; pUef@ 20 cef@ v_yfyg?ykvif;tm; pUef@ 20 cef@ v_yfyg?ykvif;tm; pUef@ 20 cef@ v_yfyg?

(Step 3)Shake the bottle for 20 seconds.

(tqif h 2)(tqif h 2)(tqif h 2)(tqif h 2)(tqif h 2)ykvif;. 3 yH k 4 yH kcef@ a&jznfhyg?ykvif;. 3 yH k 4 yH kcef@ a&jznfhyg?ykvif;. 3 yH k 4 yH kcef@ a&jznfhyg?ykvif;. 3 yH k 4 yH kcef@ a&jznfhyg?ykvif;. 3 yH k 4 yH kcef@ a&jznfhyg?

(Step 2)Fill the bottle 3/4 full with water.

(tqif h 1)(tqif h 1)(tqif h 1)(tqif h 1)(tqif h 1)yxrqHk;t}udrf oiftoHk;jyKaom ykvif;jzpfv#ifyxrqHk;t}udrf oiftoHk;jyKaom ykvif;jzpfv#ifyxrqHk;t}udrf oiftoHk;jyKaom ykvif;jzpfv#ifyxrqHk;t}udrf oiftoHk;jyKaom ykvif;jzpfv#ifyxrqHk;t}udrf oiftoHk;jyKaom ykvif;jzpfv#ifaocsmpGm aq;a=umyg?aocsmpGm aq;a=umyg?aocsmpGm aq;a=umyg?aocsmpGm aq;a=umyg?aocsmpGm aq;a=umyg?

(Step 1)Wash the bottle well the first time you use it.

tyl"gwfESif haea&mif. (,lAGD-at-a&mifjcnf) tm;tyl"gwfESif haea&mif. (,lAGD-at-a&mifjcnf) tm;tyl"gwfESif haea&mif. (,lAGD-at-a&mifjcnf) tm;tyl"gwfESif haea&mif. (,lAGD-at-a&mifjcnf) tm;tyl"gwfESif haea&mif. (,lAGD-at-a&mifjcnf) tm;toHk;jyKI ao;i,faomydk;rGm;rsm;udktoHk;jyKI ao;i,faomydk;rGm;rsm;udktoHk;jyKI ao;i,faomydk;rGm;rsm;udktoHk;jyKI ao;i,faomydk;rGm;rsm;udktoHk;jyKI ao;i,faomydk;rGm;rsm;udk aoapjcif;aoapjcif;aoapjcif;aoapjcif;aoapjcif;

Inactivation of micro-organisms by sun ray(UV-A-radiation) and thermal treatment.

aea&mifjcnf toHk;jyKI a&tm; ydk;oef@pifjcif;DISINFECTION OF WATER BY SUN

ISSUE 24, JUNE, 2004 65

(tqif h 5)(tqif h 5)(tqif h 5)(tqif h 5)(tqif h 5)ykvif;rsm;tm; aea&mif jcnfatmuf&S d oGyftrd k;y kvif;rsm;tm; aea&mif jcnfatmuf&S d oGyftrd k;y kvif;rsm;tm; aea&mif jcnfatmuf&S d oGyftrd k;y kvif;rsm;tm; aea&mif jcnfatmuf&S d oGyftrd k;y kvif;rsm;tm; aea&mif jcnfatmuf&S d oGyftrd k;jym;ay:wGi f xm;yg?jym;ay:wGi f xm;yg?jym;ay:wGi f xm;yg?jym;ay:wGi f xm;yg?jym;ay:wGi f xm;yg?

(Step 5)Place the bottles on a corrugated ironunder the sun.

rl&if; ? tufpftdk'Dtdkiftufpf ( aea&mifjcnfjzihf a&tm; ydk;oef@pifjcif;)Source: SODIS (SOLAR WATER DISINFECTION)

(tqif h 8)(tqif h 8)(tqif h 8)(tqif h 8)(tqif h 8),cktcs de fwGi f a&ud k aomufoH k ;&e f tqifoif h,cktcs de fwGi f a&ud k aomufoH k ;&e f tqifoif h,cktcs de fwGi f a&ud k aomufoH k ;&e f tqifoif h,cktcs de fwGi f a&ud k aomufoH k ;&e f tqifoif h,cktcs de fwGi f a&ud k aomufoH k ;&e f tqifoif hjzp f +y D ?jzp f +y D ?jzp f +y D ?jzp f +y D ?jzp f +y D ?

(Step 8)The water is now ready for consumption.

(tqif h7)(tqif h7)(tqif h7)(tqif h7)(tqif h7)eHeufrSnaetxd tenf;qH k ; 6 em&Dcef @ y kvif;e HeufrSnaetxd tenf;qH k ; 6 em&Dcef @ y kvif;e HeufrSnaetxd tenf;qH k ; 6 em&Dcef @ y kvif;e HeufrSnaetxd tenf;qH k ; 6 em&Dcef @ y kvif;e HeufrSnaetxd tenf;qH k ; 6 em&Dcef @ y kvif;tm; aea&mifatmufwGi f xm;yg?tm; aea&mifatmufwGi f xm;yg?tm; aea&mifatmufwGi f xm;yg?tm; aea&mifatmufwGi f xm;yg?tm; aea&mifatmufwGi f xm;yg?

(Step 7)Expose the bottle to the sun from morninguntil evening for at least six hours.

(tqif h6)(tqif h6)(tqif h6)(tqif h6)(tqif h6)tqif h5 tpm; jyKvkyfE d ki fonf?tqif h5 tpm; jyKvkyfE d ki fonf?tqif h5 tpm; jyKvkyfE d ki fonf?tqif h5 tpm; jyKvkyfE d ki fonf?tqif h5 tpm; jyKvkyfE d ki fonf?acgi f ;r d k ;ay:wGi f wifxm;jci f ;onf y kvif ;tm;acgi f ;r d k ;ay:wGi f wifxm;jci f ;onf y kvif ;tm;acgi f ;r d k ;ay:wGi f wifxm;jci f ;onf y kvif ;tm;acgi f ;r d k ;ay:wGi f wifxm;jci f ;onf y kvif ;tm;acgi f ;r d k ;ay:wGi f wifxm;jci f ;onf y kvif ;tm;oGy fr d k ;r sm;ay:wGi f aea&mi fatmufxm;jci f ;oGy fr d k ;r sm;ay:wGi f aea&mi fatmufxm;jci f ;oGy fr d k ;r sm;ay:wGi f aea&mi fatmufxm;jci f ;oGy fr d k ;r sm;ay:wGi f aea&mi fatmufxm;jci f ;oGy fr d k ;r sm;ay:wGi f aea&mi fatmufxm;jci f ;tqif h 5 tpm; jyKvkyfEd ki fonf?tqif h 5 tpm; jyKvkyfEd ki fonf?tqif h 5 tpm; jyKvkyfEd ki fonf?tqif h 5 tpm; jyKvkyfEd ki fonf?tqif h 5 tpm; jyKvkyfEd ki fonf?

(Step 6) alternative to (Step 5)Putting the bottle on the roof is analternative to placing the bottles on acorrugated iron sheet under the sun.

ISSUE 24, JUNE, 2004 67



aemufvdkufaemufygwdk@eJh orifrsm;tm;trJvdkufaepOf/ awmtkyfwtkyftwGif;Y rif;om; “0‡ukrRm”onfrsufaphvnf vrf;aysmuf avonf? tpmjywf/ a&jywfI rif;om;onf opfyifwyifatmufwGifowd

vpfvJusoGm;onf?

xdktcsdeftcg wGifopfyif apmifhewfrif; onf rif;om;tm; jrifawG@oGm;+yD; oem;pdwf jzpfay:vmw,f? ewfrif;vJ

rif;om;ukdulnD&ef udk,fxifjyw,f?

ewfrif;? ? [email protected];eJ@udk,fxifjy&ef/ igh.vufndk;ukdaxmifawmhr,f? (jrifap/-jrifapownf;)

rif;om;? ? tvdk ! bk&m;/ bk&m; ! wdrfrJzHk;ovdkarSmifvdkufwm? rdk;arSmifusw,fxifyg&J@?

ewfrif;? ? bma=umifhvJ/ igukd,fxifjyygqdk&J@eJ@/ bma=umifhrJarSmif&ovJ?[kwf+yD/ (igh&J@ukd,f xif aysmufap)

rif;om;? ? tvdk/ bk&m;&Sif ! awmufy vif;vuf vkdufwm/ b,ft&mrsm;jzpfovJ?

ewfrif;? ? (tvkd/ bk&m;/ bk&m; ! qefhusifbufyg uvm;)? igonfopfyifapmifhewfrif;jzpfonf?

toifrif;om;ukd ulnD&efukd,fxifjyjcif;jzpfonf?

rif;om;? ? uGsEkfyf 0rf;omygw,f? vrf;aysmufvkd@ tuGsEfkyf. aemufvdkufrsm;udkvnf; &SmrawG@awmhyg? qmvJ

qmw,f/ a&vJ iwfw,f? aus;Zl;jyK +yD;csufcsif;om tultnDay;ygawmh?

ewfrif;? ? uGsEfkyfulnDygrnf? odk@aomf ulnD&efoifhaomol [kwfr[kwfawmhod&efvdkygw,f?

rif;om;? ? tb,f ta=umif;a=umifh jzpfygovJ?

npfywfaomrif;om;usef;rma&;apwrmeftzGJ@ESihf ygwempf wdk@yl;wGJa&;om;onf

ISSUE 24, JUNE, 2004 69

The Prince "Wannakhonmar" was lost in the forest while he was hunting deer with his followers.Because of the lack of food and water the prince fainted under a tree.

At that moment, the spirit guard of the tree saw him and sympathised with him. So he decidedto help him by showing his appearance.

Spirit With the power of a spirit, I will raise my index finger to show my appearance.Appearance ……………..appearance.

Prince Oh! Gosh! It is as black as night. It seems like black clouds are falling down.Spirit Why! Why does it becomes dark when I say “appearance?”

OK. I will disappear.Prince Oh my Gosh! It is so bright and fluorescent ….What is it?Spirit Oh Gosh! It is just the opposite now. I am the spirit guard of this tree.

I am showing my appearance to help you.Prince I am so glad. I have lost my way and cannot find my followers. Now I am hungry

and thirsty. Please help me at once.Spirit I will help you, but I have to know whether you are the one I should help or not.Prince Why?Spirit For the moment, I will give you some fruits.

Here is a banana, a guava and a mango. Eat them!Prince Oh! There is nothing.Spirit You will see them if you have dignity.

If you do not , you will not see them.Prince Oh! More fruits. I will eat them completely and delightfully.

(The spirit guard of the tree disappears while the prince is eating the fruits)It's so delicious. I cannot even finish them all. So I will peel the fruits. Go away.(He throws the fruit peels). Now I am full. I would like to defecate. I will do itbehind the tree. (The spirit guard of the tree appears)

Spirit Look……….look. I help him with all my heart, but he spoils my surroundingswith dirt by throwing all those fruit peels and now he is defecating!!!

The Prince of DirtyHealth Messenger Team in Collaboration with Partners


ewfrif;? ? 'DtcsdefrSm/ uGsEfkyfu toifrif;om;pdwfa=ueyfap&ef opfoD;wcsdK@ay;xm;r,f?

'DrSm/ iSufaysmoD;/ refvumoD;ESifho&ufoD;rsm;yg/ pm;oHk;yg toifrif;om;?

rif;om;? ? tvdk ! bmrSrawG@&ygvm;?

ewfrif;? ? toifrSmoduQm&dSv#ifawG@&rSmaygh? oduQmr&dS&ifawmh rawG@Edkifbl;aygh?

rif;om;? ? tvdk ! opfoD;rsm;xyfay;ygOD;? uGsEfkyftukefvHk; tm;&pGm pm;r,f?

(opfyifapmifhewfrif;vJrif;om;toD;rsm;pm;aepOfaysmufuG,foGm;onf)

tvGeft&om&dSw,f/ igtm;vHk;ukefatmifrpm;Edkifawmhbl;? igtoD;rsm;ukdtcGHcGg+yD;v$ifhypf vdkufr,f?

oGm;prf;? (rif;om;onfopfoD;rsm;ukdvGifhypf&if; ajymonf) ,QK igAdkufwif;oGm; +yD/ igtD;ygcsifw,f?

opfyifaemufrSmtD;ygr,f? (opfyifapmifhewfrif;udk,fxifay:vmonf )?

ewfrif;? ? =unfhprf;/ =unfhprf;? igtpGrf;ukefulnDaomfvJ rif;om;uig&J@ae&mudk zsufpD;+yD; npfywf aya&

apw,f? opfoD;cGHrsm;v$ifhypf+yF;/ tD;vJyg aew,f? tdk/ ,ifaumif awGvnf; rsm; vdkufwm?

rif;om;ygxm;wJhtD;ESifholypfxm;wJhopfoD;cGHawG udk,ifaumifawGtHkaeygvm;? 'Drif;om;

tD;yg+yD;jyefvm+yD? igc% udk,fa&mifazsmufvkduf OF;r,f (ukd,faysmufap)?

rif;om;? ? tdkau bJ? igoufawmifhoufomjzpfoGm;+yD? tD;yg+yD;awmh/ igjyefqmvm+yD? 'DrSmopfoD;

awGusefao;w,f? igtm;vHk; pm;vdkufr,f? (opfoD;rsm;pm;+yD; aemuf/ rif;om;vJAdkufudk

EdSyf+yD;vJusoGm;)

ewfrif;? ? tdk/ 'guawmh olnpfywf+yD;/ wudk,fa&oef@&Sif;r_r&dSvkd@bJ? tck ol aoawmhr,f? 'Dvkdjzpf wm

olukd,fwdkifvkyfvdk@ ukd,fwdkifcHpm;&wmbJ? oltrd_ufudkae&mwumypfw,f? tD;yg+yD; vufraq;bl;?

npfaywJhvufeJ@vJ,ifem;xm;wJh tpm;tpmawGudk pm;w,f? 'ga=umifhaygh r=umcifol0rf;

av#ma&m*gESifhao&awmhr,f? uav;wdk@ rSwfxm;zdk@uawmh/ Tjzpf&yfrSm 0rf;oGm; tD;yg+yD;&if

vufaq;zdk@ vdktyfw,f qdkwm ygbJ? qyfjymESifhvufaq;yg?

qyfjymESifhoif.vufudkaq;yg?Wash your hands with soap

ISSUE 24, JUNE, 2004 71

Oh ……..so many flies. They are eating all those fruits peels that he threw awayand his faeces as well. Now he is coming back after defecation. I will disappearfor a while (Disappear)

Prince Ok! I feel comfortable now. After defecation, I am hungry again. Here are therest of the fruits, I will eat them all. (After eating the fruits, the prince felldown while holding his stomach)

Spirit That is because he is dirty and has no personal hygiene. He has got the diseaseand now he will die. That is because of what he has done to himself.He threw the garbage everywhere and he did not wash his hands after defecation.And with dirty hands, he ate the fruits on which the flies have landed. That is thereason he will die of diarrhoea. That is why children must remember this caseand you must wash your hands with soap after defecation.


Note:

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